| District Name | Visakhapatnam |
| Mandal Name | Pedabayalu |
| Panchayat Name | Injarai |
| VO Name | LITCHABU |
| Application Number | 4252 |
| Policy Holder Name | YENDRAPALI RAMANNA |
| Father / Husband Name | LAKSHAMAYYA |
| Gender | Male |
| Age | 28 |
| Caste | ST |
| Nominee Name | LAKSHAMAYYA |
| Nominee Age | 45 |
| Nominee Gender | Male |
| StreeNo | KUMARIGUNTA |
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