| District Name | Srikakulam |
| Mandal Name | Vangara |
| Panchayat Name | KOPPARAVALASA |
| VO Name | Bangaruvalasa |
| Application Number | 28954 |
| Policy Holder Name | Munji Usharani |
| Father / Husband Name | Krishanamurthi |
| Gender | Female |
| Age | 22 |
| Caste | BC |
| Nominee Name | Sudherkumar |
| Nominee Age | 27 |
| Nominee Gender | Male |
| RationCard | WAP010248900099 |
| StreeNo | BC Veedi |
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