Figures in Rs
Primary Borrower Secondary Borrower Total
Sum Assured Installment Premium (Exclusive of Goods and Services Tax) Sum Assured Installment Premium (Exclusive of Goods and Services Tax) Installment Premium without Goods and Services Tax Goods and Services Tax Total Installment Premium (Including Goods and Services Tax)
[SA_PRIMARY] [MODAL_PREM_PRIMARY] [SA_SECONDARY] [MODAL_PREM_SECONDARY] [MODAL_PREM] [TAX_MP] [MODAL_PREM_TAX]