| District Name | Srikakulam |
| Mandal Name | Kanchili |
| Panchayat Name | CHINNAKHOJIRIA |
| VO Name | Sri Kanchamma |
| Application Number | 22871 |
| Policy Holder Name | CHETTA MOHAN RAO |
| Father / Husband Name | JAGANAYAKULU |
| Gender | Male |
| Age | 38 |
| Caste | BC |
| Nominee Name | LAXMI |
| Nominee Age | 32 |
| Nominee Gender | Female |
| RationCard | WAP013560100336 |
| StreeNo | CHANDRUPUTTUGA |
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