| Agent | Satguru Travel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | LLW004 | ||||||||
| Effective Date | 09/16/2017 | ||||||||
| Expiry Date | 09/23/2017 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | Lemekeza Hamilton Mokiwa | ||||||||
| Policy Number | Aug/20 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | Mali | ||||||||
| Address | Lilongwe | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 43,674. | ||||||||
| Total Premium (After Tax) | 60,000 | ||||||||
| Signed by |
