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KUESIONER MENINGGAL UNTUK DIISI OLEH PENERIMA MANFAAT A. IDENTITAS TERTANGGUNG No. Polis. Nama Tertanggung Tanggal Lahir Usia Jenis Kelamin No. KTP/SIM/Passport No. Telepon Alamat B. RINCIAN 1. Tempat Kematian Rumah Rumah Sakit sebutkan Nama RS*. Lainnya jelaskan*. 2. Tanggal Kematian Penyebab Kematian Tanggal dd bulan mm tahun yy Sakit sebutkan jenis penyakit. PT Prudential Life Assurance Prudential Tower Jl* Jend. Sudirman Kav* 79 Jakarta 12910 Indonesia Tel 62 21 2995 8888 Fax 62 21...
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The manfaat kuesioner meninggal form is a form used to gather information about deceased individuals.
Family members or legal representatives of the deceased individual are required to file the manfaat kuesioner meninggal form.
To fill out the form, provide accurate information about the deceased individual including personal details, cause of death, and other requested information.
The purpose of the form is to collect data for statistical analysis and research purposes.
Information such as the deceased individual's name, age, date of birth, date of death, cause of death, and other relevant details must be reported on the form.
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