| Agent | Satguru Travel Blantyre | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | BT 004 | ||||||||
| Effective Date | 04/04/2018 | ||||||||
| Expiry Date | 04/10/2018 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | ANDRIAMASIHARIVONY/MAMY | ||||||||
| Policy Number | T/BT/STG32 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | PARIS-FRANCE | ||||||||
| Address | PO BOX 2862 | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 43,317.01 | ||||||||
| Total Premium (After Tax) | 50,464.32 | ||||||||
| Signed by |
