Group Forms
Group Name
*
Group Name *
Group Location
*
Group Location *
Contact Person
*
Contact Person *
Phone
Email
*
Email *
Group Constitution
Yes
No
Group Registered
Yes
No
No of Members
*
No of Members *
Currency
*
Currency *
Frequency Of Contribution
Per Month
Monthly Contribution Amount
Monthly Contribution Amount
Per Claim
Per Claim Contribution Amount
Per Claim Contribution Amount
Payout Amount per Member
member
Member Amount
Member Amount
spouse
Spouse Amount
Spouse Amount
child
Child Amount
Child Amount
sibling
Sibling Amount
Sibling Amount
parent
Parent Amount
Parent Amount
Number of Siblings (Brother & Sister / Brother & Sister In-Laws to the Main Member)
*
Number of Siblings (Brother & Sister / Brother & Sister In-Laws to the Main Member) *
Number of Parents (Parents / Parents In-Law to the Main Member)
*
Number of Parents (Parents / Parents In-Law to the Main Member) *
Number of Claims in the last one year
Total Number of Claims
*
Total Number of Claims *
Number of Member Claims
*
Number of Member Claims *
Number of Sibling Claims
*
Number of Sibling Claims *
Number of Spouse Claims
*
Number of Spouse Claims *
No of Parent Claims
*
No of Parent Claims *
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