| District Name | Srikakulam |
| Mandal Name | Ichchapuram |
| Panchayat Name | KEERTHIPURAM |
| VO Name | KEERTIPURAM |
| Application Number | 615 |
| Policy Holder Name | SANJUKTA NAYAK |
| Father / Husband Name | SUDHIR |
| Gender | Female |
| Age | 31 |
| Caste | BC |
| Nominee Name | SUDHIR |
| Nominee Age | 39 |
| Nominee Gender | Male |
| RationCard | WAP013702300157 |
| StreeNo | REDDYKA STREET |
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