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Family Head Detail
Name Of the Family Head
*
Contact No.
*
Email ID
*
Family Member Detail
Name Of the Policy Holder
Date Of Birth (dd/mm/yyyy)
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Relation With Family Head
Select
Self
Father
Mother
Husband
Wife
Brother
Sister
Uncle
Aunt
Son
Daughter
Grand Son
Grand Daughter
Nephew
Niece
Father-in-Law
Mother-in-Law
Brother-in-Law
Sister-in-Law
Policy Detail
Policy No.
Risk/Commencement Date
Plan Name/No.
Term
Premium Term
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Sum Assured
Premium Mode
Premium
Branch
Nominee Name
Select
Yearly
Half Yearly
Quarterly
Monthly
Single
SSS
Fup Date
DD
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MM
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
YYYY
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
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Policy Holder ID
Name
Date Of Birth
Relation
Policy Holder ID
Policy No
Risk Date
Plan Name/No.
Term
Premium Term
Sum Assured
Mode
Premium
Branch
Nominee
Fup Date
For Free Insurance and Investment counseling call on + 91 9422830224 Manoj Rathi or mail at lic@manojrathi.in
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