| District Name | Visakhapatnam |
| Mandal Name | Paderu |
| Panchayat Name | Gondili |
| VO Name | Lingaputtu |
| Application Number | 9963 |
| Policy Holder Name | PALASI SRILAXMI |
| Father / Husband Name | LAXMANA RAO |
| Gender | Female |
| Age | 28 |
| Caste | ST |
| Nominee Name | LAXMANA RAO |
| Nominee Age | 28 |
| Nominee Gender | Male |
| RationCard | WAP031019200359 |
| StreeNo | LINGAPUTTU VILLAGE GONDELI POST PADERU MANDAL VISA |