| Agent | Continental Travel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | 010 | ||||||||
| Effective Date | 12/11/2017 | ||||||||
| Expiry Date | 12/16/2017 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Medical Only A-C | ||||||||
| Name of Policy Holder | MONAOSYILE VILLA MHANGO | ||||||||
| Policy Number | 084 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | PARIS | ||||||||
| Address | CC/O CONTINENTAL TRAVEL AND TOURS | ||||||||
| Number of Passengers | ONE | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 38,484.16 | ||||||||
| Total Premium (After Tax) | 54,834.05 | ||||||||
| Signed by |
