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Title: Crystal Reports - CACMBRLTR01.RPT
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09 July

P.O.Box 23807, Jeddah 21436
Saudi Arabia
CR No. 4030178881

Al Khaleejy Medical Clinic - shifa
Insurance Companies Office

Confirmation of Membership

Customer Service ‫ھﺎﺗﻒ ﺧﺪﻣﺎت اﻟﻌﻤﻼء‬
Telephone 920 023 009
Fax 920 000 724
‫ﺧﻄﺎب ﺗﺄﻛﯿﺪ ﻋﻀﻮﯾﺔ‬
‫اﻟﺴﺎدة اﻟﻤﺤﺘﺮﻣﯿﻦ‬

Dear Sir
This fax is to confirm that Mrs Saida Osama
Abdelsalam Hegazy is a member of Bupa
Arabia with the following membership details:

‫ان ھﺬا اﻟﺨﻄﺎب ھﻮ ﻟﻠﺘﺎﻛﯿﺪ ﺑﺎن اﻟﻤﺸﺘﺮك‬
Mrs Saida Osama Abdelsalam Hegazy
‫ھﻮ اﺣﺪ اﻋﻀﺎء ﺑﻮﺑﺎ اﻟﻌﺮﺑﯿﺔ وﻓﻘﺎ ﻟﻠﺒﯿﺎﻧﺎت اﻟﺘﺎﻟﯿﺔ‬



Valid Until:


Year of Birth:


‫ﺗﺎرﯾﺦ اﻟﻤﯿﻼد‬

Class Name:


‫درﺟﺔ اﻟﺘﻐﻄﯿﺔ‬


20 % up to SAR 100

‫ﻧﺴﺒﺔ اﻟﻤﺸﺎرﻛﺔ‬

Customer Name:

Al Minhaj Schools

Should she need any treatment that is
covered under her scheme, please accept
this fax instead of the membership card for
one visit only.
Please attach this fax and a copy of the
member's ID with the claim invoices.
customer service line.
Should you have any queries please contact
one of our advisers on the Bupa Arabia's
dedicated customer service line.
Yours sincerely

‫رﻗﻢ اﻟﻌﻀﻮﯾﺔ‬
‫ﺗﺎرﯾﺦ اﻧﺘﮭﺎء اﻟﺼﻼﺣﯿﺔ‬

‫اﺳﻢ اﻟﻌﻤﯿﻞ‬
‫ﻋﻨﺪ اﻟﺤﺎﺟﺔ ﻟﺘﻘﺪﯾﻢ اﯾﺔ ﺧﺪﻣﺔ ﻋﻼﺟﯿﺔ ﻣﺪرﺟﺔ ﺗﺤﺖ ﺟﺪول اﻟﻤﺰاﯾﺎ‬
‫اﻟﺨﺎص ﺑﺪرﺟﺔ اﻟﻌﻀﻮﯾﺔ اﻟﻤﺬﻛﻮرة ﺳﺎﺑﻘﺎ ﯾﺮﺟﻰ ﻗﺒﻮل ھﺬا‬
‫اﻟﺨﻄﺎب ﻛﺒﺪﯾﻞ ﻟﺒﻄﺎﻗﺔ اﻟﻌﻀﻮﯾﺔ وذﻟﻚ ﻟﻤﺮة واﺣﺪة ﻓﻘﻂ‬

‫ﯾﺮﺟﻰ ارﻓﺎق ھﺬا اﻟﺨﻄﺎب ﻣﻊ اﻟﻤﻄﺎﻟﺒﺔ ﻋﻨﺪ ارﺳﺎﻟﮭﺎ اﻟﻰ ﺑﻮﺑﺎ‬
‫ﻓﻲ ﺣﺎل وﺟﻮد اﯾﺔ اﺳﺘﻔﺴﺎرات اﻟﺮﺟﺎء ﻋﺪم اﻟﺘﺮدد ﻓﻲ اﻻﺗﺼﺎل ﻋﻠﻰ‬
‫اﻟﮭﺎﺗﻒ اﻟﻤﺠﺎﻧﻲ ﻟﺨﺪﻣﺎت اﻟﻌﻤﻼء‬.

‫ﻣﻊ اﻃﯿﺐ اﻟﺘﺤﯿﺎت‬

Mohammed AlAmri
Customer Service
Bupa Arabia for Cooperative Insurance – Al-Rawdah St., Al-Khalediyah Dist. - PO Box 23807, Jeddah 21436, Saudi Arabia – CR No. 4030178881 - Authorised Capital SR 400,000,000 – Paid Up Capital SR 400,000,000
400,000,000 ‫ رأس اﻟﻤﺎل اﻟﻤﺼﺮح ﺑﮫ‬-‫ رﯾﺎل ﺳﻌﻮدي‬400,000,000 ‫ – رأس اﻟﻤﺎل اﻟﻤﺪﻓﻮع‬4030178881 .‫ ت‬.‫ اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﯿﺔ اﻟﺴﻌﻮدﯾﺔ – س‬21436 ‫ ﺟﺪه‬23807 ‫ ب‬.‫ﺑﻮﺑﺎ اﻟﻌﺮﺑﯿﮫ ﻟﻠﺘﺄﻣﯿﻦ اﻟﺘﻌﺎوﻧﻲ – ص‬

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