| Claim Details |
| District Name | East Godavari |
| Mandal Name | Rajanagaram |
| Claim Code | 24041400003 |
| Policy No | G0000178 |
| Lic / India First ID | 10629 |
| Appno No. | 01042805004010105301 |
| Policy Holder Name | Bavanijansilaxmibhai shatree |
| Father/Husband Name | anatharamsing shatree |
| Loan Amount | 40000 |
| Incident Date | 09/05/2013 |
| Incident Place | kimmuru |
| Cause | Fever |
| Status | Forms Received |