| District Name | Visakhapatnam |
| Mandal Name | Ananthagiri |
| Panchayat Name | KIVARLA |
| VO Name | Mother Thersa |
| Application Number | 5147 |
| Policy Holder Name | Vanthala Nageswara Rao |
| Father / Husband Name | Burs |
| Gender | Male |
| Age | 26 |
| Caste | ST |
| Nominee Name | Vanthala Eswaramma |
| Nominee Age | 22 |
| Nominee Gender | Female |
| RationCard | yap030613500401 |
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