| District Name | East Godavari |
| Mandal Name | Kotananduru |
| Panchayat Name | K.O.AGRAHARAM |
| VO Name | K.O. Agraharam |
| Application Number | 7653 |
| Policy Holder Name | THOTADA JAYA |
| Father / Husband Name | NOOKARAJU |
| Gender | Female |
| Age | 26 |
| Caste | SC |
| Nominee Name | YELETI NOOKARAJU |
| Nominee Age | 27 |
| Nominee Gender | Male |
| RationCard | WAP040501200149 |
| StreeNo | SC COLONY |
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