Endorsement Detail Report for Monthly Billing

(E-Invoice System)
Policy 28365859

Month JAN-2024

PolicyNo Risk No ClassNo Endt.No Entry Date Entry Month Member Code
1 28365859 1 1 11 04-Jan-2024 JAN-2024 002277587974001
2 28365859 1 1 11 04-Jan-2024 JAN-2024 002277587974101
3 28365859 1 1 11 04-Jan-2024 JAN-2024 002277587974201
4 28365859 1 1 11 04-Jan-2024 JAN-2024 002277587974211
5 28365859 1 1 11 04-Jan-2024 JAN-2024 002277587974221
6 28365859 1 1 12 10-Jan-2024 JAN-2024 001110452586001
7 28365859 1 4 13 18-Jan-2024 JAN-2024 002538294477001
8 28365859 1 2 14 21-Jan-2024 JAN-2024 001108740364001

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Member Name NATIONALITY NAME Dependents ID Endt.Effective Date
Abdullah Hakhm Salih Jalad Jordan 2277587974 04-Jan-2024
Alaa Hussam Aliaoudi Jordan 2059904579 04-Jan-2024
Joory Abdullah Jalad Jordan 2444479295 04-Jan-2024
Zyad Abdullah Jalad Jordan 2368341968 04-Jan-2024
Rahma Abdullah Jalad Jordan 2523957609 04-Jan-2024
Abdulrahman Mubark Aldossari Saudi Arabia 1110452586 10-Jan-2024
Soikat Mia Bangladesh 2538294477 17-Jan-2024
Albatul Faisal Alarfaj Saudi Arabia 1108740364 21-Jan-2024

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Del Date EmpID Relation Gender BirthDate Dept.Code Type
04-Jan-2024 Employee M 01-Oct-1984 Member Deletion
04-Jan-2024 Spouse F 09-Mar-1989 Member Deletion
04-Jan-2024 Daughter F 09-Dec-2016 Member Deletion
04-Jan-2024 Son M 25-Mar-2014 Member Deletion
04-Jan-2024 Daughter F 26-Jun-2022 Member Deletion
10-Jan-2024 Employee M 22-Nov-1999 Member Deletion
112233 Employee M 15-Sep-2001 Member Addition
21-Jan-2024 Employee F 15-Sep-1999 Member Deletion
TOTAL:
VAT:

GRAND TOTAL:

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 Credit Debit SUB Loction Invoice NO
1,356.90 0.00 121289831
2,431.42 0.00 121289831
0.03 0.00 121289831
683.62 0.00 121289831
895.01 0.00 121289831
946.00 0.00 121760528
0.00 121.00 101849255
847.00 0.00 122991872
7,160.00 121.00 -7,039.00
1,074.00 18.15 -1,055.85

-8,094.85

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