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Premium Certificate for the purpose of deduction under Section 80 D of Income Tax (Amendment) Act, 1986.
Policy No : P/122112/05/2022/002282 Type of Policy : Senior Citizens Red Carpet
Issue : 122112 - Branch Office – Coimbatore
Office
Address : 1st Floor, DBMS Complex, Tatabad,
Gandhipuram, Coimbatore – 641 012.
This is to certify that MR. SHANKAR GURUSWAMY has paid Rs 51230 (Total Premium: Indian Rupees Fifty-One
Thousand Two Hundred Thirty only) towards premium for Hospitalization Insurance vide Policy No:
P/122112/05/2022/002282 for the Period 05/05/2023 To 04/05/2024 issued on 22-APR-23.
Payment received by Cheque/Credit/Debit Card vide Receipt No: 4326352537 Receipt Date: 22-APR-23
Note: This Certificate must be surrendered to the Insurance Company for issuance of fresh Certificate in case of
Cancellation of the Policy or any alteration in the Insurance affecting the Premium.