52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>02/28/2019</StartDate>
  <EndDate>03/07/2019</EndDate>
  <DestinationPlan>Czech Republic</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Sujeewa</Firstname>
    <Middlename/>
    <Lastname>Dissanayake</Lastname>
    <Age>46</Age>
    <Dob>08/11/1972</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>02/28/2019</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>229 Little Clove Road</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>New York</State>
      <City>Staten Island</City>
      <Postcode>10301</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>ndissa@live.com</Email>
    <Phone>
      <Home>7184159194</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Nihal Dissanayake</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4100400425747337</CreditcardNumber>
      <NameonCreditcard>Nihal Dissanayake</NameonCreditcard>
      <CreditcardExpirationMonth>2</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2021</CreditcardExpirationYear>
      <CreditcardAmount>12.0</CreditcardAmount>
      <CreditcardCodeNumber>454</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
d76cc03d
701928921

<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>701928921</PolicyNumber><UserName>d76cc03d</UserName><Password>d76cc03d</Password></PolicyDetails></RegistrationRes>