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Please provide us with your weight and height.

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We need to ask you a few questions before proceeding further.

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Q1 / Q4

Are you a smoker?

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Q2 / Q4

Have you ever suffered from stroke, diabetes, anaemia, hepatitis, heart, or circulation disorders, kidney diseases, tumour or cancerous growth, physical or mental disability or other disorder?

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Q3 / Q4

Have any of your parents, brothers or sisters suffered, or died from, any of the above illness before the age of 60?

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Q4 / Q4

Have you had, or been recommended for, tests or counselling in connection with sexually transmitted diseases, hepatitis or HIV, blood transfusion or advised to abstain from donating blood?

Yes No

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RM 50,000


Sum Insured
RM 70,000

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