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MAGMA HDI GENERAL INSURANCE COMPANY LTD. PROPOSAL FORM ERRORS AND OMISSION INSURANCE POLICY (COMMERCIAL) DOCTORS AND MEDICAL PRACTITIONERS This proposal must be signed. All questions must be answered.

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Maghlip222v032021 onehealth page 1 is a form used to report health information for a specific period of time.

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Information such as patient demographics, medical history, treatments, and outcomes must be reported on maghlip222v032021 onehealth page 1.

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