| District Name | Srikakulam |
| Mandal Name | Etcherla |
| Panchayat Name | S.S.R.PURAM |
| VO Name | S.S.R.PURAM |
| Application Number | 235 |
| Policy Holder Name | Modalavalasa Sarada |
| Father / Husband Name | Venkata Ramana |
| Gender | Female |
| Age | 50 |
| Caste | BC |
| Nominee Name | Venkata Ramana |
| Nominee Age | 49 |
| Nominee Gender | Male |
| RationCard | wap010890000087 |
| StreeNo | Chinnarao palli |
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