| District Name | Anantapur |
| Mandal Name | Rolla |
| Panchayat Name | BOMMAGONDANAHATTI |
| VO Name | SreeLakshmi |
| Application Number | 3332 |
| Policy Holder Name | THIPPERANGAPPA GARI R MUDLIGIRIYAPPA |
| Father / Husband Name | THPPERANGAPPA |
| Gender | Male |
| Age | 31 |
| Caste | SC |
| Nominee Name | RATHNAMMA |
| Nominee Age | 28 |
| Nominee Gender | Female |
| RationCard | WAP1263008A0118 |
| StreeNo | MALLASAMUDRAM |