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MaXX Group Care
MaXX Cancer Care
MaXX Secure
MaXX Travel Care
SME MaXX Cancer Care
Sum Insured :
5 Lakhs
Premium : Rs.
Please Enter DOB
Age eligibility 18-60 years
Personal Information
Title
MR
MS
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Gender
MALE
FEMALE
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Address Information
Is the above address same for permanent address.
Medical Underwriting
Do you have any Pre-existing diseases?
YES
NO
Nominee Details
Relation
MOTHER
FATHER
WIFE
HUSBAND
SON
DAUGHTER
BROTHER
SISTER
GRAND FATHER
GRAND MOTHER
MOTHER IN LAW
SISTER IN LAW
BROTHER IN LAW
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