| District Name | Chittoor |
| Mandal Name | Peddamandyam |
| Panchayat Name | PEDDAMANDYAM |
| VO Name | MASAMMA |
| Application Number | 14829 |
| Policy Holder Name | MITTA RAMASUBBAIAH |
| Father / Husband Name | M BUCHAIAH |
| Gender | Male |
| Age | 45 |
| Caste | SC |
| Nominee Name | M ESWARAMMA |
| Nominee Age | 38 |
| Nominee Gender | Female |
| RationCard | WAP100100400207 |
| StreeNo | MITTAMALAPALLE |
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