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First Name
Middle Name
Last Name
Card Number
Select your preferred Plan
Plan 1
Plan 2
Plan 3
Plan 4
Room and Board per day (max 31 days)
₱
1,000
₱
2,500
₱
2,500
₱
2,500
Maximum Benefit Limit (MBL) per illness
₱
10,000
₱
25,000
₱
50,000
₱
100,000
Easy
Monthly Premium
₱
310
₱
670
₱
830
₱
1,060
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