| District Name | Visakhapatnam |
| Mandal Name | Kasimkota |
| Panchayat Name | Sundarayyapeta |
| VO Name | SUNDARAYYAPETA GRAMA SANGAM |
| Application Number | 9751 |
| Policy Holder Name | KESEREDDY NAGARATNAM |
| Father / Husband Name | GOGADA RAJU BABU |
| Gender | Female |
| Age | 28 |
| Caste | BC |
| Nominee Name | RAJUBABU |
| Nominee Age | 37 |
| Nominee Gender | Male |