Policy No:
Details of Addition
Date of
Date of
Date of Birth Commence
Sr Employee Joining
Name of Insured (DD/MM/Y Age Gender Relation Sum Insured ment Designation/Category/ Grade
No ID (DD/MM/Y
YYY) (DD/MM/Y
YYY)
YYY)
Base Policy Top Up
42841 Maya Rani Kar 1/Jan/1949 75 female mother 150000 75000 12/9/2024