| District Name | Prakasam |
| Mandal Name | Naguluppalapadu |
| Panchayat Name | RAPARLA |
| VO Name | JALAJEEVANI |
| Application Number | 12801 |
| Policy Holder Name | Kasi Visalakshi Jagarlamudi |
| Father / Husband Name | Sai Prasad |
| Gender | Female |
| Age | 43 |
| Nominee Name | Sai Prasad |
| Nominee Age | 41 |
| Nominee Gender | Male |
| RationCard | WAP084503100048 |
| StreeNo | Mattigunta |