| District Name | East Godavari |
| Mandal Name | Kotananduru |
| Panchayat Name | S.R.PETA |
| VO Name | Surapurajupeta |
| Application Number | 7662 |
| Policy Holder Name | MORTHA KUMARI |
| Father / Husband Name | APPARAO |
| Gender | Female |
| Age | 36 |
| Caste | SC |
| Nominee Name | SATHISH CHANDRA |
| Nominee Age | 29 |
| Nominee Gender | Male |
| RationCard | WAP0405004A0083 |
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