| District Name | Visakhapatnam |
| Mandal Name | Araku Valley |
| Panchayat Name | Madala |
| VO Name | Musiriguda |
| Application Number | 6209 |
| Policy Holder Name | KILLO KRISHNA |
| Father / Husband Name | BALAJI |
| Gender | Male |
| Age | 28 |
| Caste | ST |
| Nominee Name | GULABI |
| Nominee Age | 18 |
| Nominee Gender | Female |
| RationCard | YAP030518100128 |
| StreeNo | MUSIRIGUDA |
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