| District Name | Y.S.R(Kadapa) |
| Mandal Name | Chapad |
| Panchayat Name | T.O.PALLI |
| VO Name | T O PALLI |
| Application Number | 7378 |
| Policy Holder Name | SREENIVASULU PEDDASUBBIGALLA |
| Father / Husband Name | VENKATASUBBAIAH |
| Gender | Male |
| Age | 20 |
| Caste | SC |
| Nominee Name | VENKATASUBBAIAH |
| Nominee Age | 48 |
| Nominee Gender | Male |
| RationCard | WAP111403000142 |
| StreeNo | SC COLONY |