| Agent | Satguru Travel Blantyre |
|---|
| Agent Code | BT 004 |
|---|
| Effective Date | 12/04/2017 |
|---|
| Expiry Date | 12/06/2017 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | MR.ANDREW SAMSON CHAMANZA |
|---|
| Policy Number | T/BT/STG23 |
|---|
| Country of Origin | MALAWI |
|---|
| Destination Area | JOHANNESBURG-SOUTH AFRICA |
|---|
| Address | BLANTYRE
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| MR.ANDREW SAMSON CHAMANZA |
MS003133 |
38 |
41,310.50 |
|
|---|
| Net Premium (Before Tax) | 41,310.50 |
|---|
| Total Premium (After Tax) | 41,310.50 |
|---|
| Signed by |  |
|---|
