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Online Claim Iintimation
Name of Insured
*
:
Insured Address
*
:
City
*
:
Policy No
*
:
Policy Period
*
:
To
Name of Patient
*
:
Date Of Hospitalization
*
:
Nature Of Disease
*
:
Name & Address Of Hospital
*
:
Name Of treating Doctor
*
:
Estimated Amount of expenses
*
:
Other Detail, if Any
:
Place
:
Date
:
Sender’s Name
*
:
Sender's E-Mail
*
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Contact Us
2nd floor, NBCC House, Opp. Ahmedabad Stock Exchange, Nr. Sahjanand College, Ambawadi
Ahmedabad - 380015 Gujarat, India. Email :
inquiry@anmolmedicare.com
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