| District Name | Srikakulam |
| Mandal Name | Polaki |
| Panchayat Name | CHALLAYAVALASA |
| VO Name | Challayvalasa |
| Application Number | 11002 |
| Policy Holder Name | Chintu Raju |
| Father / Husband Name | Biyaraginaidu |
| Gender | Female |
| Age | 38 |
| Caste | BC |
| Nominee Name | Venkata Naidu |
| Nominee Age | 20 |
| Nominee Gender | Male |
| RationCard | WAP012171900210 |
| StreeNo | Challayavalasa |
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