ANANDA Digital Proposal Data Sheet

NAME		AADHAR NO		AADHAR LINKED MOBILE NO	IF AVAILABLE AADHAR VID NO

DATE OF BIRTH		GENDER		FATHER NAME	MOTHER NAME
		Male Female
IF DIFFERENT FROM AADHAR ADDRESS THEN CURRENT ADDRESS NOTE HERE

EMAIL ID		Marital Status		Education Qualification
		Married Unmarried
Place of Birth		PAN (IF AVAILABLE)		Name of Spouse

Occupation		Nature of duty		Annual Income

Name of present Employer		Number of years service		Are you registered under GST Act?
				Yes No
Previous Policy Details		Family History			Tax Assessee?
Policy Numbers			Live age	Death Age	Cause of Death
		FATHER
		MOTHER
		SISTER
		BROTHER
		SPOUSE
		KIDS
State of Health		Height		Weight
Bank Name	Account Number		Branch Name	IFSC Code

Nominee Name			Age	Relationship

Nominee AADHAR NO	Nominee Bank Name	Nominee Account Number		Nominee Branch Name	Nominee IFSC Code

As Usual Health History			For Female Cases
			Are you pregnant now? Yes No
			Caesarian Section? Yes No
Husband's Full Name:			Any Gynaecology Alignment? Yes No
Husband's Occupation:			Annual Income: