This document appears to be a proposal form for an Arogya Rakshak health insurance plan from LIC. It collects personal details of the principal insured.Arogya Raksha- Proposal Form- UIN: UIIHLGP22008V032122. LIC's Arogya Rakshak (Plan No. 906, UIN : 512N318V01). Proposals can be considered on the basis of income shown in the proposal form and using multiple of 5 for all ages.