| District Name | Prakasam |
| Mandal Name | Dornala |
| Panchayat Name | PEDDA DORNALA |
| VO Name | Iyenamukkalagrameenajeevanopadulasangam |
| Application Number | 19217 |
| Policy Holder Name | zadda guravaaiah |
| Father / Husband Name | yerraiah |
| Gender | Male |
| Age | 39 |
| Caste | SC |
| Nominee Name | priskilla |
| Nominee Age | 35 |
| Nominee Gender | Female |
| RationCard | wap080701100014 |
| StreeNo | ayinamukkala |