| Agent | Abdul Mageed | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | 001 | ||||||||
| Effective Date | 09/11/2019 | ||||||||
| Expiry Date | 09/12/2019 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Medical Only A-C | ||||||||
| Name of Policy Holder | Marshall Dyton | ||||||||
| Policy Number | mwf45 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | Canada | ||||||||
| Address | Bhana House, Second Floor, Room 11 | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 8000 | ||||||||
| Service Fees | 0 | ||||||||
| Total Premium (After Tax) | 11000 | ||||||||
| Signed by |
