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Best life insurance and investment advisor in Ludhiana/ Best financial advisor in Ludhiana – We analyse your needs and recommend plan accordingly.
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Name:
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Nomination Name:
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Alcoholic Drinks:
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No
Narcotics:
Yes
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Any other drugs:
Yes
No
Tobacco in any form:
Yes
No
Whether any of the following health related issues mentioned in a,b,c is/are faced by you ? *
a) During last 5 years did you consult a Medical Practitioner for any ailment requiring treatment for more than a week?
Yes
No
b) Have your ever been admitted to the hospital or nursing home for general check up, observation, treatment or operation?
Yes
No
c) Have you remained absent from the place of work on grounds of health during the last 5 years?
Yes
No
I am fully fit and I am not taking any medicine of BP / Sugar.
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