Baseline Survey Format fo Grama Volunteer

S.N Benef. Name as per

Block/ Mandal Name Gram Panchayat Name Village Name Habitation Name Benef. Id Family Head
o Aadhar Card

1 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU MUPIDI SATYAVATHI MUPIDI CHIRANJEVI

2 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU PEDAPUDI ACHIYAMMA PEDAPUDI KALYANAM

3 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU PEDAPUDI VARALAXMI PEDAPUDI RAMANA

4 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU PILLI VARALAXMI CHINDADA THATALU

5 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

6 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

7 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

8 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

9 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

10 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

11 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

12 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

13 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

14 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

15 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

16 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

17 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

18 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

19 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

20 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

21 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

22 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

23 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

24 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

25 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU

Note1. Communicate GP wise list within the mandal to the Village Secretariat(GP) for collecting the information
2. If any one of the household is not found in the SBM hab directory, Add that beneficiary details in the habitation list with other details as mentioned in the format
3. If the household is not existing, mention"No" in that particular field
4. Get the Scheme details(name & Ids etc.,) from IMIS website(Procedure attached)
rvey Format fo Grama Volunteers

if No toilet,
Is having
wherther covered Whether
Category Is Having household If Yes,
Father/Husband SC/ST/GE in SBM (G)/ household Scheme
Gender (BPL/APL RATION CARD No ADHAR CARD No Phone No Toilet (Yes tap (Private/ Scheme Id Remarks
Name NERAL NREGS/Housing/ existing name
) / No) connection( Public)
LOB and Other (Yes / No)
Yes / No)
Programmeres.

MUPIDI CHIRANJEVI F BPL SC WAP034002300088 817532781349 9908071330 YES YES NO

PEDAPUDI KALAYANAM F BPL SC WAP034002300070 248224082408 9959402229 YES NO NO

PEDAPUDI RAMANA F BPL SC YAP034002300067 349931596270 9959402229 YES NO NO

CHINDADA THATALU F BPL SC WAP034002300491 315410584470 9494684579 YES YES NO

 List of Beneficiaries identified under NOLB (NO one Left Behind ) category in Visakhapatnam District.

S.N Block/ Mandal Gram Panchayat Benef. Name as Father/Husband Category RATION CARD ADHAR CARD
Village Name Habitation Name Family Head Gender SC/ST/GENERAL Phone No Remarks
o Name Name per Aadhar Card Name (BPL/APL) No No

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

Notew - benefficiary Name as per Adhar Card , otherwise data will not be ported in IMIS Website
 Baseline Survey Format fo Grama Volunte

S.N
Block/ Mandal Name Gram Panchayat Name Village Name Habitation Name Benef. Id Benef. Name as per Aadhar Card Family Head
o

1 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU AMALAKANTI VARAHALAMMA VARAHALAMMA

2 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU AMALAKANTI KRISHNA KRISHNA

3 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU AMALAKANTI NAGAMANI SATYANARAYANA

4 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU KOLLI GANGAMMA GANGAMMA

5 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU PINAPOTHUNA NARAYANAMMA NARAYANAMMA

6 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU PINAPOTHUNA LAKSHMI PARVATHI SATHISH

7 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU CHINDADDA NARAYANAMMA NARAYANAMMA

8 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU YETTULA LAKSHMI LAKSHMI

9 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU CHINDADDA NARASINGAARAO NARASINGAARAO

10 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU KONDAPU LAKSHMI SATTIBABU

11 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU NAGARAJU CHIVITILOVA

12 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU NESTHALU CHINDADA CHINAPENTAYYA

13 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU CHINDADA APPALARAJU

14 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU CHINDADA SEETHARAM

15 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU CHINDADA RAJUBABU

16 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU CHINDADA DASU

17 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU MUPPIDI PEDAMMALU

18 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU UPPATI CHITTIBABU

19 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU CHINDADA RAMBABU

20 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU CHINDADA APPARAO

21 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU KAKI DASU

22 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU KODI VIJAY

23 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU PALIVELA MAREMMA

24 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU KORIPALI ANJIBABU

25 SRAYAVARAM PENUGOLLU PENUGOLLU PENUGOLLU CHINDADA APPAYAMMA

PEDDAPUDI SURYARAO

MORTHA KALYANAM
 MORTHA SIVA

CHINDADA SATYAVATHI

TOMMUDRU LAKSHMI

GORINTALLA VENKAYAMMA

CHINDADAMEENA KUMARI

SARIPALLI SARASVATHI

annam venkataramana Annam venkaramana

POTHU SATYA POTHU SATYA

ANNAM SESHAMMA ANNAM SESHAMMA

KONAGANI KASULU KONAGANI KASULU

PANDINLLA CHINNABAI PANDILLA CHINNABAI

ANNAM VANKATI ANNAM VEAKATI

SARIPALLI VENKATA LAKSHMI SARIPALLI VENKATALAKSHMI

SARIPALI SATYAVATHI

DHAMMU PARVATHI

YELAMANCHILI NAGARATNAM

NUNNA NOOKARATNAM

KORRA APPLANAIDU

MOLLI DURGA

MOLLI VEERAMANI

NEGISETTI SATYA

NEGISETTI LOVALAXMI

KORIBILLI SOMULAMMA

AMALAKANTI RAVAYAMMA

BARIPALLI SYAMALA KUMARI

AKKIREDDI SIVA PARAVATHI

KOLL I LAXMI

KONA DURGA BHAVANI

KONA LOVA LAXMI

PALAPARTHI NAGAMANI

PARLA LAKSHMI

DUDI VARALAXMI

SARIPALLI LOVATALLI
 chandaka Laxmi

sarvasiddi varalaxmi

Kona seetamma

kolli rajya laxmi

kolli ammaji

bheemaraju lova laksmi marinayya

bheemaraju sheshu naidu

bheemaraju Naga narashima raju nookaraju

bheemaraju Venkata satyanarayana nookaraju

bheemaraju mangamma mangamma

bheemaraju govindu govindu

bheemaraju appalanaidu appalanaidu

nakkula varahalamma nookaraju

bheemaraju appalanarasa appalanarasa

pochina nagalokeshwararao nagalokeshwararao

Pappu adi LAKSHMI satyanarayana

NAKKA SIRISHA BABURAO

UDDANDAM SIRISHA APPALAKONDA

DARLA RAMANA NOKAYYA

DARLA AMMAJI RAMANA

GORLA BHAVANI NAGESH

GORLA MANGA RAMANA

KARRI APPALANARASA NAGESWARRAO

CHAPPA KONDAMMA DEVULLU

KORIMILLI SIRISHA APPALARAJU

GINJALA PARVATHI BABUJI

SARIPALLI NAGARATNAM apparao

ALLU APPARAO ALLU APPARAO

ALLU NOOKARAJU ALLU NOOKARAJU

MAMIDI LAXMI RAJU

GORLA BULOKA BULOKA

Note1. Communicate GP wise list within the mandal to the Village Secretariat(GP) for collecting the information
2. If any one of the household is not found in the SBM hab directory, Add that beneficiary details in the habitation list with other details as mentioned in the format
3. If the household is not existing, mention"No" in that particular field
4. Get the Scheme details(name & Ids etc.,) from IMIS website(Procedure attached)
urvey Format fo Grama Volunteers

if No toilet,
Is having
wherther covered Whether
Category Is Having household If Yes,
Father/Husband SC/ST/GE in SBM (G)/ household Scheme
Gender (BPL/APL RATION CARD No ADHAR CARD No Phone No Toilet (Yes tap (Private/ Scheme Id Remarks
Name NERAL NREGS/Housing/ existing name
) / No) connection( Public)
LOB and Other (Yes / No)
Yes / No)
Programmeres.

RAMU F BPL GEN WAP034002300414 96963991556 9100141474 NO YES YES PUBLIC

PANDAVALU M BPL GEN WAP034002300044 288239273681 NO YES YES PUBLIC

SATYANARAYANA F BPL GEN RAP0340023001953 805802517948 9502984564 NO YES YES PUBLIC

SURYUDDU F BPL GEN WAP034002300247 608592641917 9247139362 NO YES YES PUBLIC

APPALARAJU F BPL GEN WAP034002300163 943459449676 9912274969 NO YES NO

SATHISH F BPL GEN RAP0340023001704 250439991804 9912274969 NO YES YES PUBLIC

PENTAYYA F BPL SC WAP035002300293 548736388969 9398598483 NO YES NO PUBLIC

VEERAJU F BPL SC WAP0340023A0023 726580601437 8790465693 NO YES NO PUBLIC

YERRANUKALU M BPL SC WAP034002300095 362154342267 9666613960 NO YES NO PUBLIC

SATTIBABU M BPL SC JAP034002300089 518143101471 8179262113 NO YES NO PUBLIC

CHIVITI LOVA F BPL SC JAP034002300088 662734394149 7569214788 NO YES NO PUBLIC

NESTHALU M BPL SC WAP034002300076 991666984471 9652287449 NO YES NO PUBLIC

CHINA PENTYYA M BPL SC WAP0340023A0024 381561438540 9652287449 NO YES NO PUBLIC

RATTALU M BPL SC WAP034002300096 687435258826 7036033464 NO YES NO PUBLIC

RATTALU M BPL SC WAP034002300083 254982995785 7680014296 NO YES NO PUBLIC

NARSAYA M BPL SC WAP034002300062 998368715559 8978417294 NO YES NO PUBLIC

BABURAO F BPL SC YAP0340023A0036 659133802017 7013450133 NO YES NO PUBLIC

ARJANA M BPL SC JAP034002300079 319359003398 9292457482 NO YES NO PUBLIC

RAMUDU M BPL SC RAP034002301701 788827780325 7093295074 NO YES NO PUBLIC

MAHALAKSHMI M BPL SC WAP034002300112 341770832940 9550911491 NO YES YES PUBLIC

NAGABHUSHAN M BPL SC RAP034002301711 963857866400 8712105341 NO YES YES PUBLIC

APPARAO M BPL SC RAP034002300830 653641196723 7993462634 NO YES YES PUBLIC

APPARAO M BPL SC YAP034002300475 727820923131 9959925591 NO YES YES PUBLIC

VENKANNA M BPL SC WAP034002300080 980017080125 8500938676 NO YES YES PUBLIC

APPARAO F BPL SC WAP034002300107 374741748442 9100301477 NO YES YES PUBLIC

NESTHALU M BPL SC WAP034002300085 373994061103 9121653550 NO YES NO PUBLIC

APPARAO F BPL SC WAP034002300308 716716971803 7095210574 NO YES YES PUBLIC

 APPARAO F BPL SC JAP034002300052 3227095113039 7330831661 NO YES YES PUBLIC

APPARAO F BPL SC WAP034002300075 629150472340 7780713108 NO YES YES PUBLIC

DEVULLU F BPL SC WAP034004000335 ;595347373899 7013731291 NO YES YES PUBLIC

NUKALLU F BPL SC WAP034002300079 454518182141 9849814747 NO YES YES PUBLIC

DARABABU F BPL SC WAP034002300072 270740681755 8125912654 NO YES YES PUBLIC

apparao f BPL gen wap034002300218 634404471999 9581381570 NO YES NO

BUCHHAYYA M BPL GEN WAP034004000071 692330321334 9640813297 NO YES NO

RAMAMA F BPL GEN WAP03400400035 805975029427 6300934766 NO YES NO

APPALANAIDU F BPL GEN JAP034004000035 91109827499 8096569688 NO YES NO

KANNAYA M BPL GEN WAP034004000040 322230407411 6303766679 NO YES NO

MANDALARAO M BPL GEN WAP034004000366 219306431543 9848647124 NO NO NO

SURIBABU F BPL GEN WAP034004000472 896846846692 9912036928 NO NO NO

SEETHARAM F BPL GEN WAP034002300166 321043952055 7730043949 NO YES NO

SATYANARAYANA F BPL GEN WAP034002300220 714290702214 9247404671 NO YES NO

RAJU F BPL GEN WAP034002300198 491546064018 7702681068 NO YES NO

SURIBABU F BPL GEN WAP034002300246 944447792603 9100139051 NO YES NO

RAMANA F BPL GEN RAP034002301492 624971671579 9553418944 NO YES NO

GANGARAJU F BPL GEN WAP034002300378 856643033152 NO YES NO

VARAHALARAO F BPL GEN JAP034003050251 824365963584 7842529681 NO YES NO

A V V KUMAR F BPL GEN JAP034002300094 653291840909 8247632696 NO YES NO

ADINARAYANA F BPL GEN RAP034002302988 20744362640 8341858683 NO YES YES PUBLIC

SATYANARAYANA F BPL GEN WAP034002300007 313220247463 8341858683 NO YES YES PUBLIC

F BPL GEN WAP034002300171 31469066366 9989396774 NO YES NO

NOOKARAJ F BPL GEN WAP034002300164 211786074421 8096989748 NO YES NO

CHINNA BABU F BPL GEN JAP034002300033 774494440953 8074276454 NO YES NO

TATAJI F BPL GEN RAP034002601811 479883264792 9676598874 NO YES NO

RAMANA F BPL GEN WAP034002300140 703725313371 9154483823 NO YES NO

SREENU BABU F BPL GEN JAP034002300091 705816656440 9704809493 NO YES NO

N
SRINUVASMURTHY F BPL GEN RAP0340023001961 395944535509 9652798933 NO YES NO

SATTIBABU F BPL GEN WAP034003200134 200862846600 NO YES NO

NAGASWARAO F BPL GEN RAP0340023002089 367342315351 7702054121 NO YES NO

YEDUKONDALARAO CHALLARAO F BPL GEN JAP034002300034 934320230557 9290728365 NO YES NO

APPALARAJU F BPL GEN RAP034002301705 773351875568 7569558257 NO YES NO

 apparao F BPL GEN WAP034002300489 373117544205 9390865517 NO YES NO

F BPL GEN WAP034001A0357 680588945788 7997253773 NO YES NO

F BPL GEN WAP034002300048 568215526420 NO YES NO

atchannayudu F BPL GEN WAP034002300212 370421440123 8309887528 NO YES NO

nooka raju F BPL GEN WAP034002300047 941927463400 9705399808 NO YES NO

naidu M BPL GEN RAP034004001205 221642374133 8978797843 NO YES NO

narashima raju M BPL GEN WAP034004000448 948293657711 9618819869 NO YES NO

satyanarayana M BPL GEN RAP034004002610 973950318012 8367687978 NO YES NO

nookaraju F BPL GEN WAP034004000268 328163845607 9908493977 NO

nookaraju M BPL GEN JAP034002300071 687732564709 9908493977 NO

nookulu M BPL GEN WAP034004000242 745351775863 NO

nookaraju F BPL GEN WAP034004000188 497403642042 NO

tathabbai F BPL GEN WAP034004000153 650062565772 9885168660 NO

baburao M BPL GEN JAP034004000037 798811205274 7287063633 ha

satyanarayana F BPL GEN WAP0384055A0374 578351210184 6303627438 NO

BABURAO F BPL GEN JAP034101800025 993272097319 9441477163 NO

APPALAKONDA F BPL GEN WAP034002300253 372849239965 9505579892 NO

NOKAYYA M BPL GEN YAP034002300436 512036409366 9704515464 NO

RAMANA F BPL GEN WAP034002300514 456586024254 7995133679 NO

NAGESH F BPL GEN RAP034002301966 952398009818 7095680664 NO

RAMANA F BPL GEN YAP034002300183 375798362758 9248610533 NO

NAGESWARRAO F BPL GEN WAP034002300350 343931180049 7095454252 NO

DEVULLU F BPL WAP034002300324 559887389870 9860204576 NO

APPALARAJU F BPL SC JAP034002300024 819337064418 8978123154 NO

BABUJI F BPL GEN WAP034002300270 629991760653 9885972613 NO

apparao f BPL GEN WAP034002300348 766441885753 8367747664 NO

RAMULU M BPL GEN WAP034002300342 712431804742 7337303301 NO

RAMULU M BPL GEN WAP034002300229 620500131028 9000315159 NO

RAJU M BPL GEN WAP0340023A0010 508658594130 9030164181 NO

NARAYANA M BPL GEM WAP034002300195 608498032823 998934023 NO

BPL NO

BPL NO
BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL NO

BPL

BPL

BPL

BPL

BPL

BPL
BPL

BPL

BPL

BPL

BPL

BPL

BPL

BPL

BPL

BPL

BPL

BPL

BPL

BPL

BPL

BPL

BPL

YES YES PUBLIC

YES YES PUBLIC

YES YES PUBLIC