IN WHICH BRANCH OF MEDICINE VIZ., ALLOPATHY /
HOMEOPATHY / AYURVEDIC / ANY OTHER-PLEASE SPECIFY
ARE YOU A MEMBER OF ANY MEDICAL ASSOCIATION / COUNCIL?
IF SO, PLEASE STATE NAME AND ADDRESS OF SUCH ASSOCIATION /
COUNCIL WITH MEMBERSHIP NO.
ARE YOU A
A) GENERAL PRACTITIONER /GENERAL PHYSICIAN / SURGEON
B) PATHOLOGIST / RADIOLOGIST
C) CONSULTING PHYSICIAN
D) ANESTHETIST / PLASTIC SURGEON
NOTE: IF SPECIALIST, PLEASE SPECIFY YOUR LINE OF SPECIALIZATION.
SPECIFY FACILITIES SUCH AS DISPENSING FACILITY, X-RAY,
RADIATION THERAPY, SCANNING, ECG, SONOGRAPHY, MRI,
ETC., AVAILABLE / OPERATED BY YOU OR UNDER YOUR CONTROL.
ARE THESE FACILITIES BEING MAINTAINED THROUGH REGULAR
SERVICE CONTRACTS WITH THE MANUFACTURERS/ SPECIALIZED
SERVICING AGENCIES?
COVERAGE FOR UNQUALIFIED STAFF?
WORLDWIDE JURISDICTION
LIMIT OF INDEMNITY (AOA:AOY 1:1)
IF YOU WISH TO COVER HIGHER SUM ASSURED