| District Name | Srikakulam |
| Mandal Name | Polaki |
| Panchayat Name | TALASAMUDRAM |
| VO Name | Talasamudram |
| Application Number | 11008 |
| Policy Holder Name | Prgada Surayakumari |
| Father / Husband Name | Venkataramanagandhi |
| Gender | Female |
| Age | 43 |
| Caste | BC |
| Nominee Name | Venkataramanagandhi |
| Nominee Age | 49 |
| Nominee Gender | Male |
| RationCard | wap012174700146 |
| StreeNo | Talasamudramu |
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