| District Name | Visakhapatnam |
| Mandal Name | Araku Valley |
| Panchayat Name | Baski |
| VO Name | Gaybanda |
| Application Number | 4074 |
| Policy Holder Name | VANTHALA RAMBABU |
| Father / Husband Name | ARJUNA |
| Gender | Male |
| Age | 21 |
| Caste | ST |
| Nominee Name | SWAPNA |
| Nominee Age | 18 |
| Nominee Gender | Female |
| RationCard | WAP030518200139 |
| StreeNo | PAKANAGUDA |
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