M
ANSI
I
NVESTMENT
Datasheet for LIC
Email ID
:naeemthekedar@yahoo.com
Mobile No.
09869150465 / 09820369944
CompanyDetails
Personal
Address
FamilyDetails
MedicalDetails
Employer's Name
Employer's Address
Pincode
City
India
Name
Designation
Length Of Service
Sex
Male
Female
Father's name
Previous Policy LIC No.
Date of birth
Place of birth
Annual income
Education qualification
Mobile
Email ID
Present address
Pin Code
City
Copy To Residence
India
Residential address
Pin Code
City
India
Person
Age
Stated Health
Cause Of Death
Father’s
Good
Deceased
Mother’s
Good
Deceased
Brother/s
Good
Deceased
Good
Deceased
Good
Deceased
Good
Deceased
Sister/s
Good
Deceased
Good
Deceased
Good
Deceased
Good
Deceased
Spouse
Good
Deceased
Children’s
Good
Deceased
Good
Deceased
Good
Deceased
Good
Deceased
Whether there is any accident/operation/injury
Yes
No
Whether admitted to hospital
Yes
No
Height
Weight
Specs
Yes
No