Agent | Libertas | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | 001 | ||||||||
Effective Date | 10/10/2013 | ||||||||
Expiry Date | 10/31/2013 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Medical Only A-C | ||||||||
Name of Policy Holder | Marshall Dyton | ||||||||
Policy Number | T464656 | ||||||||
Country of Origin | Malawi | ||||||||
Destination Area | Europe | ||||||||
Address | ohdh | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
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Net Premium (Before Tax) | 1000 | ||||||||
Total Premium (After Tax) | 1165 | ||||||||
Signed by |