Health Insurance

Policy DetailsCustomer Full Name

Gender (eldest member for the policy)

Male

Female

Select customer’s family members to insure

Self

Spouse

First Child

Second Child

Third Child

Fourth Child

Sum Insured

Vitrak Insurance Brokers Private Limited | Direct Broker (Life & General) | IRDAI Registration No – 826 | Registration Code – IRDAI/DB875/2021 | Valid till 18-06-2025CIN – U66000DL2021PTC377736

Reg. Address: Flat 7, Plot No. 103, Himversha Apartment, Patparganj, New Delhi – 110092Correspondence Address: 3rd Floor, BLM Towers, Plot 63, Sector 44, Gurgaon – 122001

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