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Home Policy Capture
ENTER YOUR POLICY DETAILS & WE WILL SERVICE THEM FOR FREE
Family Head Detail
Name Of the Family Head
*
Contact No.
*
Email ID
*
Family Member Detail
Name Of the Policy Holder
Date Of Birth (dd/mm/yyyy)
DD
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MM
Jan
Feb
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Apr
May
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Sep
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Nov
Dec
YYYY
1936
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2015
2016
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2019
2020
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2022
2023
2024
Relation With Family Head
Select
Self
Father
Mother
Husband
Wife
Brother
Sister
Uncle
Aunt
Son
Daughter
Grand Son
Grand Daughter
Nephew
Niece
Father-in-Law
Mother-in-Law
Brother-in-Law
Sister-in-Law
Policy Detail
Policy No.
Risk/Commencement Date
Plan Name/No.
Term
Premium Term
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
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20
21
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23
24
25
26
27
28
29
30
31
MM
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
YYYY
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
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1967
1968
1969
1970
1971
1972
1973
1974
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1976
1977
1978
1979
1980
1981
1982
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1984
1985
1986
1987
1988
1989
1990
1991
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1993
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1998
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2001
2002
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2100
2101
2102
2103
2104
Sum Assured
Premium Mode
Premium
Branch
Nominee Name
Select
Yearly
Half Yearly
Quarterly
Monthly
Single
SSS
Policy Holder ID
Name
Date Of Birth
Relation
Policy Holder ID
Policy No
Risk Date
Plan Name/No.
Term
Premium Term
Sum Assured
Mode
Premium
Branch
Nominee
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