| District Name | Srikakulam |
| Mandal Name | Burja |
| Panchayat Name | PALAVALASA |
| VO Name | PALAVALASA |
| Application Number | 544 |
| Policy Holder Name | Mandvakuriti Sujathakumari |
| Father / Husband Name | Ganapathirao |
| Gender | Female |
| Age | 40 |
| Caste | BC |
| Nominee Name | Ganapathirao |
| Nominee Age | 45 |
| Nominee Gender | Male |
| RationCard | Yap0111037A0017 |
| StreeNo | Mainveedi |