| District Name | Visakhapatnam |
| Mandal Name | Araku Valley |
| Panchayat Name | Kothabhalluguda |
| VO Name | Janamguda |
| Application Number | 3733 |
| Policy Holder Name | Mosya Vamsi |
| Father / Husband Name | Dharma |
| Gender | Male |
| Age | 26 |
| Caste | ST |
| Nominee Name | Suvarna |
| Nominee Age | 42 |
| Nominee Gender | Female |
| RationCard | WAP030518400325 |
| StreeNo | Janamguda |
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