Max Bupa Health Insurance Company Limited

Regd. Office: Max House, 1 Dr Jha Marg, Okhla, Phase-III, New Delhi - 110020
Corporate Office: B-1/I-2, Mohan Cooperative Industrial Estate,Mathura Road, New Delhi-110044

Duplicate Receipt(Customer Copy)

Receipt No. : NOC/61/7994251

NOC/20/1234807 Receipt Date : 29/10/2022 06:53:41 PM
Mode of Payment : Online Payment Collection Date : 29/10/2022 06:53:41 PM
Received With Thanks From : Piyush Kumar Dubey
Amount : 7851
26000
Amount in Words : Rs. Seven
TwentyThousand EightOnly
Six Thousand Hundred and Fifty One Only
SNo. Customer Id Application No. Amount (inclusive of all taxes)*
1 2000884321 8879986431 26000
* Amount inclusive of GST @18%

Pan No. : AAFCM7916H

GSTIN : 07AAFCM7916H1ZA
Issuing Office / State Code: Corporate Office, Mohan Estate / 7
SAC Code/Type of Service: 997133/General Insurance Services
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2) Acceptance of premium do not constitute acceptance of risk. Commencement of risk is subject to technical clearance and acceptance by Underwriting Team of Max Bupa Health Insurance Company Limited.
3) In case of non acceptance/rejection of proposal by the Company on technical grounds, premium deposited will be refunded without interest.

This is a computer generated receipt, does not require any signatures

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Max Bupa Health Insurance Company Limited

Regd. Office: Max House, 1 Dr Jha Marg, Okhla, Phase-III, New Delhi - 110020
Corporate Office: B-1/I-2, Mohan Cooperative Industrial Estate,Mathura Road, New Delhi-110044

Duplicate Temporary Receipt(Office Copy)

Receipt No. : NOC/20/1234807 Receipt Date : 14/08/2020 7:20:28 PM

Mode of Payment : Online Payment Collection Date : 14/08/2020 7:20:28 PM
Received With Thanks From : Sarvpriya Singh Arora
Amount : 7851
Amount in Words : Rs. Seven Thousand Eight Hundred and Fifty One Only
SNo. Customer Id Application No. Amount (inclusive of all taxes)*
1 2000884321 81100178080 7851
* Amount inclusive of GST @18% and 1% Kerala Flood Cess (Applicable for Kerala state only)

Pan No. : AAFCM7916H

GSTIN: : 07AAFCM7916H1ZA
Issuing Office / State Code: Corporate Office, Mohan Estate / 7
SAC Code/Type of Service: 997133/General Insurance Services