State Life

Accidental & Indemnity Product (150K Coverage)

Accidental Death

Premium Amount:

PKR 188

Cover Limit:

Rs 150,000

Policy Fee:

Rs 50

Total

PKR 238

Personal Details

DOB*

First Name*

Last Name*

CNIC Number*

CNIC Issuance Date*

CNIC Expiry Date*

Profession

Father / Husband Name*

Mother Name*

Contact Details

Mobile No.*

Email*

Address*

City*

Beneficiary 1*

Keely Mcknight