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Tagum Himsug Plus Activation (TEST)

This is a test link only. Go to https://chmf.coop/thpi

Plan Type *

Rider
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Branch *

Himsug Plus Card Number * e.g.: 9999-999999

Date Purchased *

Date of Activation *

Name of Card Holder *

Home Address *

Date of Birth *

Age *

Age Unit

Premium

Contact Number *

Email