Policy No.: P/700019092/00753/0 Previous Policy No.

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Proposer's Code: 3629867 Issuing Office Code: 03148119
Proposer's Name: KHAMITOV SINDOR Issuing Office Name: Online Business
Address: Address:
UZBEKISTAN 20 Gracechurch Street,
London,
United Kingdom,
EC3V 0BG

Phone No.: +998936940625 Toll Free No.: 0800 111 4004

E-mail id: khamitovsindorabdurafikovic@gmail.com E-mail id: info@axahealth.co.uk
Proposal date: 23.04.2024 Fulfiller Code: SO700002 Sector: Urban
Date of Inception of first policy: 24.04.2024
Renewal Year: NEW
Receipt No.: 1272007864
Receipt Date: 23.04.2024
Service Tax: 169GBP
PERIOD OF INSURANCE FROM: 24.04.2024 TO: 24.04.2025

SCHEME - DESCRIPTION: 1 ADULT

PLAN - DESCRIPTION: BASIC
LIMIT OF COVERAGE: 125,000 GBP

Name of the Insured Sex Date of Birth ID Card No.

KHAMITOV SINDOR MALE 26.04.1984 3629867