| 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 | Thokozani Josephine Ng'ombe |
|---|
| Policy Number | Aug/32 |
|---|
| Country of Origin | MALAWI |
|---|
| Destination Area | India |
|---|
| Address | Lilongwe Malawi
|
|---|
| Number of Passengers | 2 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| Thokozani Josephine Ng'ombe & Orianna Kuwala Mwenyekonde |
MA030607,MA861727 |
36 & 5 months old |
55.83 |
|
|---|
| Net Premium (Before Tax) | 41,314 |
|---|
| Service Fees | 5000 |
|---|
| Total Premium (After Tax) | 53,500 |
|---|
| Signed by |  |
|---|
