Employee self with Spouse and upto two kids (Company Paid)

Employee Name Employee dependents Relationship Emp. ID. DOB (dd/mm/yyyy)Gender

XX XX Employee BE-555 25/11/1980 M
XX YY Spouse BE-555 22/03/1982 F
XX AA Son BE-555 12/01/2012 M
XX AB Daughter BE-555 21/06/2015 F

Employee Parents if want to insured (Employee self paid basis)

Employee Name Employee dependents Relationship Emp. ID. DOB (dd/mm/yyyy)Gender
XX ZA Father BE-555 18/10/1950 M
XX ZB Mother BE-555 04/08/1953 F