Photo ID proof Photo ID proof

to accompany to accompany
this card at the this card at the
time of time of
hospitalzation hospitalzation
Name : ANJU GAUTAM Relation : WIFE Name : HEMANT KUMAR Relation : SON

Age : 33 Sex : F Age : 4 Sex : M

Policy No. : 272500/48/2020/2157 Policy No. : 272500/48/2020/2157

Valid Up To : 31-May-2020 Valid Up To : 31-May-2020

TPA CARD NO. : 061910381 TPA CARD NO. : 061910383

Photo ID proof Photo ID proof

to accompany to accompany
this card at the this card at the
time of time of
hospitalzation hospitalzation
Name : SHIVJI Relation : SELF Name : SUKAR RAM Relation : FATHER

Age : 45 Sex : M Age : 81 Sex : M

Policy No. : 272500/48/2020/2157 Policy No. : 272500/48/2020/2157

Valid Up To : 31-May-2020 Valid Up To : 31-May-2020

TPA CARD NO. : 061910380 TPA CARD NO. : 061910384

Photo ID proof Photo ID proof

to accompany to accompany
this card at the this card at the
time of time of
hospitalzation hospitalzation
Name : JAGARANI DEVI Relation : MOTHER Name : HIMANSHU KUMAR Relation : SON

Age : 73 Sex : F Age : 9 Sex : M

Policy No. : 272500/48/2020/2157 Policy No. : 272500/48/2020/2157

Valid Up To : 31-May-2020 Valid Up To : 31-May-2020

TPA CARD NO. : 061910385 TPA CARD NO. : 061910382