| District Name | Srikakulam |
| Mandal Name | Kanchili |
| Panchayat Name | TALATAMPARA |
| VO Name | Gaayathri |
| Application Number | 22909 |
| Policy Holder Name | MADINA BHAVANI |
| Father / Husband Name | RAJESH |
| Gender | Female |
| Age | 24 |
| Caste | BC |
| Nominee Name | RAJESH |
| Nominee Age | 29 |
| Nominee Gender | Male |
| RationCard | WAP013595100478 |
| StreeNo | MAIN STREET |
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