| District Name | Visakhapatnam |
| Mandal Name | Golugonda |
| Panchayat Name | Patha mallempeta |
| VO Name | KOTTAPALEM GRAMAPEDALAIKYASANGAM |
| Application Number | 9911 |
| Policy Holder Name | sana durga devi |
| Father / Husband Name | soomaraju |
| Gender | Female |
| Age | 18 |
| Caste | SC |
| Nominee Name | jayamma |
| Nominee Age | 47 |
| Nominee Gender | Female |
| RationCard | wap031501200429 |
| StreeNo | jogampeta |