| Agent | Manica Travel |
|---|
| Agent Code | LL016 |
|---|
| Effective Date | 02/03/2019 |
|---|
| Expiry Date | 02/08/2019 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | MTIMUNI CHISANU ALUMBENI MKUWANDA |
|---|
| Policy Number | T/RT620 |
|---|
| Country of Origin | MALAWI |
|---|
| Destination Area | UGANDA |
|---|
| Address | MANICA TRAVEL
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| MTIMUNI CHISANU ALUMBENI MKUWANDA |
MA083835 |
33 |
41,314.20 |
|
|---|
| Net Premium (Before Tax) | 48,131.04 |
|---|
| Service Fees | 20000 |
|---|
| Total Premium (After Tax) | 68,131.04 |
|---|
| Signed by |  |
|---|
