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      Proposer Name Enter Your Full Name Aadhar Number Aadhar full No Enter Aadhar Mobile Aadhar Linked Mobile DATE OF BIRTH Exp: 10/JAN/1998 Qualification Exp: MBA
      GENDER Married Status Father Name Mother Name Place of Birth
      Policy Deliver Address
      Bank Account No A/c Holder Name Bank Name IFSCODE Account Type
      Height Weight ID Marks Any Health Issue Old Policy Details
      Annual Income Emplo. Name & Expr Nominee Name Nominee Age Relationship
      DO FILL THE FAMILY MEMBERS AGE DETAILS HERE , IN CASE DEATH ANY OF YOUR FAMILY MEMBERS PLEASE STATE DEATH OF THE MEMBERS AGE AND REASON IN THE BELOW COLUMN. (EXP:--> " AGE 56 ALIVE " <-- OR --> " AGE 85 DEATH-AGED FACTOR " <--" IF NO MEMBER STATE "N.A")
      FATHER MOTHER BROTHERS SISTERS KIDS
      APPLICABLE ONLY FEMALE PROPOSERS OTHER ENTER "N.A"
      Are You Pregnant Date of Last Delivery Misca. or Cesarean Spouse Name Spouse Job & Inc
      REQUIRED DOCUMENTS LINK GIVEN BELOW, PLS UPLOAD ALL RELAVENT DOC
      Bank Stat/Book Income Proof ITR COPYS Education Doc Aadhar Copy
      Pan Card Copy Your Email After Filed all Column plus attachments click the submit button