| District Name | Guntur |
| Mandal Name | Ipuru |
| Panchayat Name | UDIZERLA |
| VO Name | UDIJERLA GRAMAIKYA SANGHAM |
| Application Number | 2640 |
| Policy Holder Name | VANGALA ADILAKSHMI |
| Father / Husband Name | PEDA VENKAIAH |
| Gender | Female |
| Age | 33 |
| Caste | SC |
| Nominee Name | PEDA VENKAIAH |
| Nominee Age | 30 |
| Nominee Gender | Male |
| RationCard | WAP0741102200061 |
| StreeNo | SC COLONY |