| District Name | Vizianagaram |
| Mandal Name | Pusapatirega |
| Panchayat Name | KANDIVALASA |
| VO Name | SutryachandraMACS |
| Application Number | 17094 |
| Policy Holder Name | debarki eswaramma |
| Father / Husband Name | late ramakrishna |
| Gender | Female |
| Age | 32 |
| Caste | SC |
| Nominee Name | amurutha |
| Nominee Age | 10 |
| Nominee Gender | Female |
| RationCard | wap022500400208 |
| StreeNo | SC COLONY |
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