| District Name | Visakhapatnam |
| Mandal Name | Dumbriguda |
| Panchayat Name | Sovva |
| VO Name | Goppulavalasa |
| Application Number | 7183 |
| Policy Holder Name | Pati Appalaswamy |
| Father / Husband Name | Hari |
| Gender | Male |
| Age | 33 |
| Caste | ST |
| Nominee Name | Rathnamma |
| Nominee Age | 23 |
| Nominee Gender | Female |
| RationCard | WAP0304176A0132 |
| StreeNo | Goppulavalasa |
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