| District Name | Srikakulam |
| Mandal Name | Polaki |
| Panchayat Name | EDDULAVALASA |
| VO Name | Edulavalasa |
| Application Number | 11007 |
| Policy Holder Name | Muddada Tatamma |
| Father / Husband Name | Appalaswami |
| Gender | Male |
| Age | 40 |
| Caste | BC |
| Nominee Name | Sandirani |
| Nominee Age | 28 |
| Nominee Gender | Female |
| RationCard | wap012174600263 |
| StreeNo | Edulavalasa |
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