| District Name | Visakhapatnam |
| Mandal Name | Munchingiputtu |
| Panchayat Name | Kumada |
| VO Name | Kumada |
| Application Number | 4599 |
| Policy Holder Name | MATAM TIRUPATHI |
| Father / Husband Name | CHITTI PADAL |
| Gender | Male |
| Age | 37 |
| Caste | ST |
| Nominee Name | SUMITHRA |
| Nominee Age | 25 |
| Nominee Gender | Female |
| RationCard | WAP030111500062 |
| StreeNo | CHINNA CHARIYA PALLI |
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