| District Name | Anantapur |
| Mandal Name | Rolla |
| Panchayat Name | ROLLA |
| VO Name | SREE RANGANATHA K.GOLLAHATTI |
| Application Number | 3835 |
| Policy Holder Name | Dasappagari Mudlappa |
| Father / Husband Name | Dasappa |
| Gender | Male |
| Age | 28 |
| Caste | BC |
| Nominee Name | Lakshmamma |
| Nominee Age | 25 |
| Nominee Gender | Female |
| RationCard | WAP126300200282 |
| StreeNo | K Gollahatti |