Policy Number: 150100502310003603

Customer Name: MR/MRS. SANDEEP KUMAR

Premium Certificate
(For the purpose of deduction u/s 80 d of Income Tax (amendment) Act, 1986)

This is to certify that MR/MRS/MS. SANDEEP KUMAR (HRMS No. 60245015) has paid

Rs.19765.00/- towards premium for Hospitalisation Insurance vide Policy no.150100502310003603 for the period from

10/06/2023 to midnight of 09/06/2024.

For National Insurance Company Limited

Duly Constituted Authority

Place: Kolkata
Date: March, 20, 2024.

N.B.- This certificate must be returned to insurer for issuance of fresh certificate, in case of cancellation or alteration if it affects the

premium in insurance policy.

National Insurance Company Limited, Division Office - XV, National Insurance Building, 1st Floor, 8, India Exchange Place, Kolkata - 700 001.
Telephone Nos. 033-2231-9294/95/96, Fax No. 033-2231-9315 CIN No. U10200WB1906GOI001713 Email: 150100@nic.co.in Website: www.nationalinsuranceindia.com