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UIICHealth

This receipt is for a payment of Rs. 9476 from Kurian P J for their IndividualFamilyMedicarePolicy. It provides the policy number, type of policy, premium amount, CGST and SGST amounts, total amount, payment details including payment ID and instrument number, and notes on cheque realization and correspondence.

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42 views

UIICHealth

This receipt is for a payment of Rs. 9476 from Kurian P J for their IndividualFamilyMedicarePolicy. It provides the policy number, type of policy, premium amount, CGST and SGST amounts, total amount, payment details including payment ID and instrument number, and notes on cheque realization and correspondence.

Uploaded by

rejymol
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Firefox https://www.uiic.in/GCWebPortal/CoreCustomerReceip...

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UNITED INDIA INSURANCE COMPANY LIMITED


 
RECEIPT
Issuing Office 070801 / BO K.S.RAO.ROAD Receipt
10107080121106394140
code/Address : 76K.S.RAO ROAD, OPP: POPULAR BUILDING, Number :
HAMPANAKATTA575001 Collection
17/09/2021
Date :

Received with thanks from KURIAN P J (Customer ID : 23009581697, Customer GST/UIN No :Not Available) a sum of
Rs. 9476.00( Nine thousand four hundred seventy-six rupees only) as per detail given hereunder:
SL Endt/Ren/Clm/Decln Total
Policy Number Policy Type Particulars
No No Amount
Final
1 0708012821P105959693 IndividualFamilyMedicarePolicy 0 8,030.00
Premium
2 0708012821P105959693 IndividualFamilyMedicarePolicy 0 CGST 723.00
3 0708012821P105959693 IndividualFamilyMedicarePolicy 0 SGST 723.00
Total (Rounded Off) : 9,476.00
Stamp Duty : 0.00
Bank Charges : 0.00
Total Amount : 9,476.00

Instrument Details
SL Mode of Instrument Bank Branch Tagged
Payment ID Instrument Number
No Payment Date Name Name Amount
PAYMENT
Canara
1 121070801104776824 GATEWAY 20210917111212800110168297744142445 17/09/2021   9,476.00
Bank
- PAYTM
Particulars :  
GSTIN (UIIC) :   29AAACU5552C1ZF for UNITED INDIA INSURANCE COMPANY LIMITED

Cashier Initial AUTHORISED SIGNATORY


Note:
1. Receipt valid subject to realisation of cheque
2. Please quote policy no., collection no., and date in all correspondences.

1 of 1 17/09/21, 21:27

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