OUTSTANDING

REQUIREMENTS REPORT
April 01, 2023 to April 26, 2023

Agent Code : 70063758

Agent Name : LARRY EMO GUIALAL
Branch : 00184 - CHINA GOLD BRANCH

Policy Proposal Risk Bill Single Plan

Client Name Currency Premium Xrate APE Suspense UW Date Details
Number Date Status Freq Premium Code

AG: 70113804 - MARGIE TAGARO CALE

FME-FULL
MEDICAL
EXAMINATION;
MUR-
MICROURINALYSIS;
RDE-RESPIRATORY
DISORDER QUES
SERANA, MEV 17 APR 17 APR (AP); OTH-
20738235 PS 12 PHP 39.00 1.00 26,394.00 2,199.50 0.00 PLPP
XYLEF JUED VILLA 2023 2023 BORROW COPY OF
ALL TESTS DONE
FOR ASTHMA;
OTH-AND
PNEUMONIA; OTH-
AGENT'S REPORT:
VERIFY JOB DUTIES
OF PLI;

AG: 70141407 - MIKE JONES SIERRAS QUITIOL

MUR-
MICROURINALYSIS;
OTH- DUE TO
BRINGAS, MARK BUILD; OTH-
01 APR 01 APR
20666736 ELLAND PS 12 PHP 39.00 1.00 30,624.00 2,552.00 CAPTURED IMAGE 0.00 PLPP
2023 2023
CABUSOG WITH VALID ID;
FME-FULL
MEDICAL
EXAMINATION;

AG: 70145416 - SYRIL TROY JUMARITO BABATE

ANOC, IAN RAY 25 APR 25 APR

20799588 PS 12 PHP 39.00 1.00 30,000.00 2,500.00 0.00 PLPP
SULTAN 2023 2023

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