34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>01/24/2017</StartDate>
  <EndDate>02/04/2017</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Kamala</Firstname>
    <Middlename/>
    <Lastname>Chandrakirana</Lastname>
    <Age>56</Age>
    <Dob>10/01/1960</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>01/24/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Jalan Tanjung 18</Address1>
      <Address2/>
      <Country>Indonesia</Country>
      <State/>
      <City>Jakarta</City>
      <Postcode>10350</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>yvonne@urgentactionfund.org</Email>
    <Phone>
      <Home>4155230360</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4484610002843673</CreditcardNumber>
      <NameonCreditcard>Yvonne Leland</NameonCreditcard>
      <CreditcardExpirationMonth>11</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>67.68</CreditcardAmount>
      <CreditcardCodeNumber>466</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
f7851b86
ARS-02-0031924
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0031924</PolicyNumber><UserName>f7851b86</UserName><Password>f7851b86</Password></PolicyDetails></RegistrationRes>