| District Name | Prakasam |
| Mandal Name | Dornala |
| Panchayat Name | YADAVALLI |
| VO Name | YADAVALLIGRAMEENAJEEVANOPADULASANGAM |
| Application Number | 19007 |
| Policy Holder Name | Kothapalli Ruthamma |
| Father / Husband Name | Vijaya raju |
| Gender | Female |
| Age | 36 |
| Caste | SC |
| Nominee Name | Vijaya raju |
| Nominee Age | 35 |
| Nominee Gender | Male |
| RationCard | wap0807001a0241 |