Agent | Continental Travel | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | 010 | ||||||||
Effective Date | 11/06/2017 | ||||||||
Expiry Date | 11/09/2017 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Medical Only A-C | ||||||||
Name of Policy Holder | Audrey Mwala | ||||||||
Policy Number | 079 | ||||||||
Country of Origin | MALAWI | ||||||||
Destination Area | SOUTH AFRICA | ||||||||
Address | C/O CONTINENTAL TRAVEL AND TOURS | ||||||||
Number of Passengers | ONE | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 39,804.82 | ||||||||
Total Premium (After Tax) | 46,435.79 | ||||||||
Signed by |