| District Name | Srikakulam |
| Mandal Name | Mandasa |
| Panchayat Name | SABAKOTA |
| VO Name | BUDAMBO WMACS LTD |
| Application Number | 20211 |
| Policy Holder Name | SAVARA NETAJI |
| Father / Husband Name | XXXXX |
| Gender | Male |
| Age | 38 |
| Caste | ST |
| Nominee Name | KANTHAMMA |
| Nominee Age | 33 |
| Nominee Gender | Female |
| RationCard | RAP013306200467 |
| StreeNo | BUDAMBO |
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