| Agent | Satguru Travel Blantyre | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | BT 004 | ||||||||
| Effective Date | 11/27/2017 | ||||||||
| Expiry Date | 12/02/2017 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | MANG'ANDA MERCY | ||||||||
| Policy Number | T/BT/STG21 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | NAIROBI | ||||||||
| Address | PO BOX 2862 | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 41,310.50 | ||||||||
| Total Premium (After Tax) | MK70,000.00 | ||||||||
| Signed by |
