| Agent | Satguru Travel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | LLW004 | ||||||||
| Effective Date | 10/22/2017 | ||||||||
| Expiry Date | 10/29/2017 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | Chifundo Marilyn Petuma Teputepu | ||||||||
| Policy Number | Aug/31 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | India | ||||||||
| Address | Lilongwe Malawi | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 41,314 | ||||||||
| Service Fees | 5000 | ||||||||
| Total Premium (After Tax) | 53,500 | ||||||||
| Signed by |
