| District Name | West Godavari |
| Mandal Name | Kovvur |
| Panchayat Name | DOMMERU |
| VO Name | DOMMERU JYOTHI MACTCS LTD |
| Application Number | 28012 |
| Policy Holder Name | DURGA DEVI MENNI |
| Father / Husband Name | SRINU |
| Gender | Female |
| Age | 20 |
| Nominee Name | MENNI SRINU |
| Nominee Age | 40 |
| Nominee Gender | Male |
| RationCard | WAP051604000068 |
| StreeNo | SARASWATHI SCHOOL ST |