Customer Details Gold Plus – Aarogya Healthcare

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Name *

Email *

Phone number 1 *

Phone number 2

Plan Name *

Name on the card 1

Name on the card 2

Address

Name on the card 3

Landmark

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City

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Pincode

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Contains :2 preventive health checkup + 2 dental package + 3 doctor consultations + 4 family discount cards – (valid for one year*)

– Covers FOUR FAMILY MEMBERS in the family

– This plan is a combination of Preventive healthcare + Primary Healthcare

– Preventive Health care package – Complete cash less programs

– Primary Health care Package – A discount card that facilitates discounts on all health related expenses

– Free Doctor consultations

– This plan is recommended for individual families comprising four members