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Get Discharge Voucher

SATION AND DOMICILIARY HOSPITALISATION BENEFIT POLICY CLAIM FORM Claim No. CL Issuance of this form does not amount to admission of any liability under the claim on the part of the Insurers. Please give the following information correctly and completely to enable the company to process your claim promptly. If the claim is under Personal Accident Insurance, please complete a Personal Accident Claim Form. 1. Name of the Insured For Office use only (In whose name policy is issued ) (INITIALS) D.

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