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PREMIUM PAYMENT ACKNOWLEDGEMENT
Acknowledgement No.:852700238471 Date:04/05/2020
Policy No. 079123/HP90313
Policy Holders Name MR NITIN GUPTA
E-mail nitingupta.gupta46@gmail.com Contact No. 8237292456
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Plan Name oj Allan Heath Protect Medial Insurance - HP92412431
Life Insured | (MR NITIN GUPTA
Sum Assured 00,000 Policy Commencement Date | e8108/2020
Policy Term Year Premium Payment Term 1 Year
Premium Due Date ‘wos021 Premium Payment Frequency | Annual
Premium Received 21480 Payment Mode ver
Amount in Words ‘Rupees ‘Twenty Seven Thousand Four Hundred Fifty Only”
Agent Code HHee90000060 | Agent Name WEBSALES
This is system generated acknowledgement hence requires no signature.
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