| Agent | Satguru Travel Blantyre | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | BT 004 | ||||||||
| Effective Date | 03/22/2018 | ||||||||
| Expiry Date | 03/29/2018 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | ANSAH JANE MAYEMU | ||||||||
| Policy Number | T/BT/STG30 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | NADI-FIJI | ||||||||
| Address | PO BOX 2862 | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 62,261.55 | ||||||||
| Total Premium (After Tax) | 72,534.71 | ||||||||
| Signed by |
