| District Name | Srikakulam |
| Mandal Name | Seethampeta |
| Panchayat Name | KODISA |
| VO Name | MUTYALU VO |
| Application Number | 28663 |
| Policy Holder Name | BANGARI SAVARA |
| Father / Husband Name | KESAVARAO |
| Gender | Female |
| Age | 24 |
| Caste | ST |
| Nominee Name | KESAVARAO |
| Nominee Age | 39 |
| Nominee Gender | Male |
| RationCard | YAP011331100095 |
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