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Get Pbby

AIM FORM The issue of this Form does not constitute admission of liability. Please return this Form duly completed together with relevant Reports/Bills/Certificates from concerned authorities. POLICY NUMBER: 1 2 a) Name of the Emigrant (Insured Person) b) Age c) Address d) Occupation e) Passport Number f) Valid upto g) Details of work permit h) Name of the employer/sponsor i) Place of work/employment Personal Accident Claim: a) Name of the Insured Person. b) Where did the accident occur? c) G.

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