| Agent | Head Office |
|---|
| Agent Code | BT0001 |
|---|
| Effective Date | 03/25/2018 |
|---|
| Expiry Date | 04/05/2018 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | JESSIE SCHOLASTICA BISIKA |
|---|
| Policy Number | 013 |
|---|
| Country of Origin | Malawi |
|---|
| Destination Area | ISRAEL |
|---|
| Address | Malawi Telecoms Limited
P.O. BOX
Blantyre
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| JESSIE SCHOLASTICA BISIKA |
MA021737 |
40 |
K40,979.22 |
|
|---|
| Net Premium (Before Tax) | K47,740.79 |
|---|
| Total Premium (After Tax) | K47,740.79 |
|---|
| Signed by |  |
|---|
