Store Registration – rxmedico.online

Login Setup for Store

This user ID and password will be used in Store Login after admin approval.

Store Login User ID *Password *Plan

Store Identity

Store Name *Store TypeOwnership TypeWebsiteStore LogoStore Photo / Front Photo

Owner & Authorized Person

Owner NameOwner MobileOwner EmailAuthorized PersonAuthorized MobileAuthorized Email

Legal & Pharmacy Licence

Drug Licence No.Licence Issue DateLicence Valid UptoGSTINPANTrade LicenceShop RegistrationFSSAIDrug Licence CopyGST Certificate

Registered Pharmacist

Pharmacist NamePharmacist Registration No.Pharmacist MobilePharmacist Certificate

Address, Contact & Timing

Full AddressCityDistrictStatePINLandmarkLatitudeLongitudePhoneWhatsAppAlternate PhoneEmergency PhoneOpening TimeClosing TimeWeekly Off

Services Required

Bank, UPI & Invoice

Bank NameAccount No.IFSCUPI IDUPI Merchant NameUPI Scan QR ImageAllow Cash at Store for Doctor BookingEnable this if patients may book online and pay consultation fee at your store/clinic.Invoice Prefix

I confirm that the information is true and the store will follow applicable pharmacy, billing and data privacy rules.