| District Name | Srikakulam |
| Mandal Name | Regidiamadalavalasa |
| Panchayat Name | KODISA |
| VO Name | KOdisa |
| Application Number | 22456 |
| Policy Holder Name | CHUKKA CHINNAMADU |
| Father / Husband Name | VENKATANAIDU |
| Gender | Female |
| Age | 35 |
| Caste | BC |
| Nominee Name | VENKATANAIDU |
| Nominee Age | 30 |
| Nominee Gender | Male |
| RationCard | WAP010305700277 |
| StreeNo | main road |
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