મંડપ હાયરર્સ ઈલેકટ્રીકલ એસોસિએશન
https://mhea.in/
૫ લાખનો અકસ્માત વિમો
Rs. 5 Lakh Accident Insurance Form
Firm Name (પેઢીનું નામ) *
Merchant Name (વેપારીનું નામ) *
Date of Birth *
Age *
Blood Group
Select
A+
B+
O+
AB+
A-
B-
O-
AB-
Address *
Village/City *
Taluka *
District *
Pincode *
Mobile No. *
WhatsApp No.
Email
Nominee Details (વારસદાર)
Nominee Name *
Relation *
Nominee DOB
Upload Signature (સહી નો ફોટો) *
Click to Upload Signature
Submit Insurance Form
Developed by
Lexos Security
