| Agent | Satguru Travel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | LLW004 | ||||||||
| Effective Date | 10/14/2017 | ||||||||
| Expiry Date | 10/21/2017 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | Manda Chikomeni Chimudikeni | ||||||||
| Policy Number | Aug/21 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | Europe | ||||||||
| Address | Lilongwe Malawi | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 41,314 | ||||||||
| Total Premium (After Tax) | 58,000 | ||||||||
| Signed by |
