| District Name | Srikakulam |
| Mandal Name | Regidiamadalavalasa |
| Panchayat Name | LAXMIPURAM |
| VO Name | Laxmipuram Wmacvs |
| Application Number | 22346 |
| Policy Holder Name | PARAVATHI JADA |
| Father / Husband Name | NAGABHASHANARAO |
| Gender | Female |
| Age | 35 |
| Caste | BC |
| Nominee Name | NAGABHASHANARAO |
| Nominee Age | 33 |
| Nominee Gender | Male |
| RationCard | wap010303700047 |
| StreeNo | main road |
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