Thu Jan 19 05:07:26 PKT 2017  
 
 

 

Motor Insurance

 

 
Individual Name*
 
C.N.I.C Number* {99999-9999999-9}
 
Mobile*  -  {0999-9999999}
 
Landline  - 
 
Email*
 
 
Mailing Address*
 
 
 
City*


 
 
Sum Insured*
 
Registration Number* {AFR-2017}
 
Vehicle Model*


 
 
Model Year*
 
Engine Number*
 
Chassis Number*
 
Tracker Installed*
 
Tracker Installed By
 
Tracker Company


 
 
 
Premium*