| Agent | Marsh |
|---|
| Agent Code | MM001 |
|---|
| Effective Date | 10/22/2019 |
|---|
| Expiry Date | 12/05/2019 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | Geoffrey Chikoma Mkandawire |
|---|
| Policy Number | T/STB/473/BT |
|---|
| Country of Origin | Malawi |
|---|
| Destination Area | London Heathrow-United Kingdom |
|---|
| Address | P.O Box 1111
Blantyre
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| Geoffrey Chikoma Mkandawire |
MA859836 |
28 |
63,905.25 |
|
|---|
| Net Premium (Before Tax) | 63,905.25 |
|---|
| Total Premium (After Tax) | 75,449.62 |
|---|
| Signed by |  |
|---|
