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21/12/2024

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تأمينات صحية - استمارة طلب عرض سعر فردي صحي

fullname
nationality
birthdate
gender
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Address
Email
Tel
mob
socialstatus
num_family
wh
birthdate
children 1
Birthdate
children 2
birthdate
children 3
Birthdate
children 4
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coverinsurance
limitedsyrian
widesyrian
syrianjorden
insurancetype
inhospital
in_outhospital
dentalclinic
comm1

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