Health Insurance Certificate of Continuity - Individual

‫ ﺍﻷﻓﺮﺍﺩ‬- ‫ﺷﻬﺎﺩﺓ ﺇﺳﺘﻤﺮﺍﺭﻳﺔ ﻓﻲ ﺑﺮﻧﺎﻣﺞ ﺍﻟﻀﻤﺎﻥ ﺍﻟﺼﺤﻲ‬

:‫ﺭﻗﻢ ﺍﻟﺸﻬﺎﺩﺓ‬
Certificate No: HQ7777701230060649

:‫ﺇﺳﻢ ﺍﻟﻤﺆﻣﻦ ﻋﻠﻴﻪ‬

Name of the Insured: ANOOJ SOMASUNDARAN NAIR

:‫ﺟﻨﺴﻴﺔ ﺍﻟﻤﺆﻣﻦ ﻋﻠﻴﻪ‬

Nationality: Indian

Gender M / F: M
:‫ ﺍﻧﺜﻰ‬/ ‫ﺫﻛﺮ‬

Birth Date: 12/08/1984

:‫ﺗﺎﺭﻳﺦ ﺍﻟﻤﻴﻼﺩ‬

784198475086918
:‫ﺭﻗﻢ ﻫﻮﻳﺔ ﺍﻟﻤﺸﺘﺮﻙ‬
Member EID:

This Certificate confirms that the insured (ANOOJ SOMASUNDARAN NAIR) has been insured with Daman as per Law No. 23/2005 and its
executive regulations of the Emirates of Abu Dhabi for the coverage period stated below:

‫ ﻹﻣﺎﺭﺓ ﺃﺑﻮﻇﺒﻲ‬23/2005 ‫ ﺍﻟﺴﻴﺪﺓ )ﺍﻧﻮﺝ ﺳﻮﻣﺎﺳﻮﻧﺪﺍﺭﺍﻥ ﻧﺎﻳﺮ( ﻣﺆﻣﻦ ﻋﻠﻴﻪ ﻣﻦ ﻗﺒﻞ ﺍﻟﺸﺮﻛﺔ ﺍﻟﻮﻃﻨﻴﺔ ﻟﻠﻀﻤﺎﻥ ﺍﻟﺼﺤﻲ – ﺿﻤﺎﻥ ﻭﻓﻘﺎ ﻷﺣﻜﺎﻡ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ‬/‫ﺗﻔﻴﺪ ﻫﺬﻩ ﺍﻟﺸﻬﺎﺩﺓ ﺑﺄﻥ ﺍﻟﺴﻴﺪ‬
:‫ﻭﻻﺋﺤﺘﻪ ﺍﻟﺘﻨﻔﻴﺬﻳﺔ ﻋﻦ ﺍﻟﻤﺪﺓ ﺍﻟﺘﺄﻟﻴﺔ‬

Policy Holder Name Policy Number Effective Date Expiry Date

‫ﺇﺳﻢ ﺣﺎﻣﻞ ﻭﺛﻴﻘﺔ ﺍﻟﺘﺄﻣﻴﻦ‬ ‫ﺭﻗﻢ ﺍﻟﻮﺛﻴﻘﺔ‬ ‫ﺗﺎﺭﻳﺦ ﺳﺮﻳﺎﻥ ﺍﻟﻮﺛﻴﻘﺔ‬ ‫ﺗﺎﺭﻳﺦ ﺇﻧﺘﻬﺎﺀ ﺍﻟﻮﺛﻴﻘﺔ‬
FIBER TECH DECOR GENERAL
11625471 02/02/2021 17/01/2022
CONTRACTING
FIBER TECH DECOR GENERAL
12151611 18/01/2022 07/12/2022
CONTRACTING

Authorised Signature: :‫ﺍﻟﺘﻮﻗﻴﻊ ﺍﻟﻤﻌﺘﻤﺪ‬

Date: 18/01/2023 :‫ﺗﺎﺭﻳﺦ‬

THIS CERTIFICATE OF CONTINUITY WILL ONLY BE VALID FOR ONE MONTH FROM THE DATE THAT IT HAS BEEN
ISSUED.

‫ﺗﺴﺮﻱ ﻫﺬﻩ ﺍﻟﺸﻬﺎﺩﺓ ﻟﻤﺪﺓ ﺷﻬﺮ ﻭﺍﺣﺪ ﻣﻦ ﺗﺎﺭﻳﺦ ﺇﺻﺪﺍﺭﻫﺎ‬

Note: This is an electronically generated document, an ‫ ﻟﻘﺪ ﺗﻢ ﺗﺤﺮﻳﺮ ﻫﺬﺍ ﺍﻟﻤﺴﺘﻨﺪ ﺇﻟﻜﺘﺮﻭﻧﻴﺎ ﻭﻻ ﻳﺤﺘﺎﺝ ﺇﻟﻰ ﺗﻮﻗﻴﻊ ﻣﻌﺘﻤﺪ ﺃﻭ‬:‫ﻣﻼﺣﻈﺔ‬
authorised signature/stamp is not required. .‫ﺧﺘﻢ‬

MEMBER CONFIDENTIAL
National Health Insurance Company – Daman (PJSC) (P.O. Box 128888, Abu Dhabi, U.A.E. Tel No. +97126149555 Fax No. +97126149550)
Doc Ctrl No.: F/1801 Version No.: 1 Revision No.: 1 Date of Issue: 17.08.2017 Page No(s).: 1 of 1