Medical Insurance Receipt

Dear Mr. Nitesh Kumar

New Mainpura Ward No 10, House No. 508
Front of Green City Apartment
Danapur, Patna, Bihar – 801503.
We acknowledge the receipt of payment of
the following health insurance policy:

Insurance
Details
Policy Holder’s Name Mr. Nitesh Kumar Policy Number 30338330201501
Plan Opted for Health Companion 008.0 Sum Insured (Rs) 8,00,000
Lacs
Commencement Date 24/07/2022 Expiry Date 23/07/2023

Net Premium (Rs.) 25,024.00

Service Tax (Rs.) 1,408.00
Education Cess (Rs.) 0.00
Gross Premium 26,432

Important Note:
 Stamp Duty
# Issuance of Policy is subject to clearance of premium paid

Details of Person Insured Age Gender Relationship to policy holder

Mr. Nitesh Kumar 32 Male Applicant

Authorised signatory