| District Name | Visakhapatnam |
| Mandal Name | Araku Valley |
| Panchayat Name | Lotheru |
| VO Name | Sirasaguda |
| Application Number | 3900 |
| Policy Holder Name | pattasi visakha |
| Father / Husband Name | jagabandu |
| Gender | Male |
| Age | 34 |
| Caste | ST |
| Nominee Name | vijaya |
| Nominee Age | 29 |
| Nominee Gender | Female |
| RationCard | wap0305183b0255 |
| StreeNo | lotheru |
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