CARE HEALTH INSURANCE LIMITED (formerly known as Religare Health Insurance Company Limited) Annual

Health Check Up Authorization Letter

Plan Name: CareV2 Silver. Date:06-Apr-2023

Policy Number:38394050
Client ID: 31983178

Dear Mr. Mahendra Chandrakant Shah Center Visit

This letter authorizes you to Annual health Check Up as per CareV2 Silver. at 10:00 AM sharp on 10-Apr-2023 at
Panvel Hospital Office-101-104, Riddhi-Siddhi, Plaza Plot No-260A, Vran Naka, Raigad Old Panvel Panvel - Maharashtra
We would request you to kindly make a note of the following, to ensure a seamless experience at the center:

1. Please carry the government ID card and a photo-copy. (Mandatory)

2. You are required to be fasting for 10-12 hrs. (Only for Blood Test)
3. You are required to maintain a full bladder at least 1 hr before the scheduled appointment.
4. Please wear comfortable clothes & running shoes (only for TMT).

Appointment Date:10-Apr-2023 Appointment Time: AM

Appointment Id:1493949
DC Add-Panvel Hospital Office-101-104, Riddhi-Siddhi, Plaza Plot No-260A, Vran Naka, Raigad Old PanvelPanvel - Maharashtra
DC Phone- 8691000263

Dear Doctor / Administrator,

As mandatory requirements please obtain the client's signature post verification of photo ID proof. Please incorporate the following
customer information on all medical reports as mentioned out here.

Age in completed years: Gender: Male / Female (please tick)

Please confirm the proof of photo id verified:

Signature of the Customer:

(In presence of the Medical examiner / Administrator)

Signature and Stamp of Hospital/DC

Self Help Portal:

Care Health Insurance Limited
https://www.careinsurance.com/self-
Regd. Office: 5th Floor, 19 Chawla House, Nehru Place, New
help-portal.html
Delhi-110019 Corresp. Office: Unit No. 604 - 607, 6th Floor,
Tower C, Unitech Cyber Park, Sector-39, Gurugram -122001 Submit Your Queries/Requests:
(Haryana) https://www.careinsurance.com/contact-
CIN: U66000DL2007PLC161503 IRDAI Regn. No. 148 us.html