Agent | Continental Travel | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | 010 | ||||||||
Effective Date | 02/24/2019 | ||||||||
Expiry Date | 02/28/2019 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Medical Only A-C | ||||||||
Name of Policy Holder | Dora Susan Makwinja | ||||||||
Policy Number | 123 | ||||||||
Country of Origin | MALAWI | ||||||||
Destination Area | SWITZERLAND | ||||||||
Address | C/O Continental Travel & Tours | ||||||||
Number of Passengers | ONE | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 40,130.20 | ||||||||
Total Premium (After Tax) | 52,751.68 | ||||||||
Signed by |