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H E A L T H I NSU R A N C E

(, P_re_m_iu_m_Re_c_e_i_pt )
Dear lv!R_ Hanumeshappa
V F308, Gaana ridhi
apartment Nagade\anahaJli

Bangalore - 560056

We o.cl<Ytowfedge the receipt of po.yw.e"'ttowards the preW1iuW1 of the fo flowi "'g health il'\Suro.Y\Ce po ficy:

Pof icy Hofder's No.Me Mrs.Gurramma Policy NuW1ber 3051540874!l7q'.l-

Pia"' Opted for FAMILYFIRST SuWl /V\Sured (Rs.) 300,000

22/08/202'.l- Expi'!:) Date 21/08/2022

,-...,
Net Prew.iuw. (
1' -l- l\._1 out of 1 Q. Q. l +-+ & Down oad
Service Tax (Rs.) _j
Krishi Ko.Iyo.I'\ Cess @ 0.53 1.l).J"f

Loo.diYtg(Rs.) 0.00
Ciross PreW1iuW1 (Rs.) 28750.50

1ssuo.Y\Ce of po ficy is S«qect to cfeo.ro.Y\Ce of preWliuw. po.id

Detai s ofpersons Insured:
Individual cover(Rs,)
Name of PersonInsured Age Gender Relat onship to policy holder (only in case of Fami y First)

Mrs. Gurramma 58 FeW1t>.fe Mother 300,000

Upo"' issut>.Y\Ce oF this receipt, o.lf previously issued teW1poro.'!:) receipts, iF t>.Y\y , related to this policy are col'\Sidered Y\ulf t>.Yld void. For
the purpose of deductioYt ul'\der sectioYt 800, the beYtefit shall be as per the provisiol'\S of the IY\COWle Tax Act, :1-q6:1- o.Y\d "-"'Y o.WleY\dWlents
Mo.de thereo.er.

In the event of non -realization of preW1iuW1, Tax beir.efits CO.>o.not be obto.iY\ed o.go.il'\St this prew.iuWI receipt

For your eligib ,- ...,

col'\Sult your t, 1' -l- l\._1 _j out of 1 Q. Q. l +-+ & oad
. .. . Down .. ... nsurance Co. Ltd.

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