| District Name | Guntur |
| Mandal Name | Achampeta |
| Panchayat Name | CHINTAPALLI |
| VO Name | SUMITRA |
| Application Number | 30871 |
| Policy Holder Name | THOTA VENKATESWARLU |
| Father / Husband Name | NARAYANA |
| Gender | Male |
| Age | 34 |
| Nominee Name | AADILAKSHMI |
| Nominee Age | 28 |
| Nominee Gender | Female |
| RationCard | WAP07070600077 |
| StreeNo | OC COLONY |
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