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Mohan Starhealth

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12 views1 page

Mohan Starhealth

Uploaded by

jqmfhknp4t
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Branch Office - T Nagar New No:55 Old No:27,2nd Floor,Vijayaraghava Road , T-Nagar,Chennai 600 017

Advance Premium Receipt


Customer Code : PI0000678194

Received from : Dr MOHAN THANIKACHALAM


Customer Address Thendralarasi
D
NO M OHAN
54/2 M
THANIIKACHALAM
,BORADING PET WEST ST, Collection No : 1815200001430
SHOLINGHUR
NO8230M,
NO ,BOARDIN, RANIPET
TNHB, JOTHI
PET DISTRICT
STREET ,SHOLINGHUR
NAGAR Collection Date
RAANIPET DISTRICT : 12/02//2023
Office Code 05/07/20
: 20
111113 - Branch Office - T Nagar
PIN CODE-631 102
Supplier GSTIN
: 33AAJCS4517L1Z5
Place of
: CHENNAI -17 State Code: -
Customer G STIN - -
: Supply
Amount Collected : Rs 15000 /- SHOLINGHUR
Rs 21642
. /- Inclusive of tax :
Amount in words : Rupees Fifteen Thousand oniy
Indian Rupees Twenty-One Thousand Six Hundred Forty-
Two Only RECEIPT ONLINE POLICY
Towards the Following : PREMIUM

S. No. Proposal Ref. No Fulfiller Code Intermediary Code Amount Collected Mode of Pay Bank Name CHQ/CC/DD No CHQ/DD/BC Dt

1 R/111113/612302034767 SH634567 BA0000460999 15000 CHEQUE STATE BANK OF INDIA 20067453426 12/02/2023
2164 6 05/07/20
2 20
For Star Health and Allied Insurance Co. Ltd

Note : Receipt Subject to realization of Cheque / DD


This is only an evidence of receipt of money by the
company Risk will commence once the proposal is Authorised Signatory
examined and accepted

IRDA Regn. No 129 Corporate Identity Number U66010TN2005PLC056649 Email id : [email protected]

Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800 Toll Free Fax No:1800-425-5522 Toll Free No:1800-425-
2255 / 1800-102-4477,CIN
:U66010TN2005PLC056649 Email :[email protected] Website :www.starhealth.in IRDAI Regn.no: 129

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