Proposal Application
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Registration No.
Password
(
Enter RegistrationNo & Password then Click Continue
)
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First Name
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Middle Name
Last Name
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Mobile number
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Email
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Password
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Re-Password
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How much amount of insurance cover do you want?
Enter Expected Coverage
(NPR)
How much premium you can pay yearly?
(NPR)
Choose Insurance Type
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Smart (Jeevan Suraksha) Term Life Insurance
Do you need our help to fill out this proposal?
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Yes