34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>09/01/2017</StartDate>
  <EndDate>10/28/2017</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Lindi</Firstname>
    <Middlename/>
    <Lastname>Wisworini</Lastname>
    <Age>58</Age>
    <Dob>05/27/1959</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>09/01/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Perumahan Cimanggu Residence Blok C No 1 . RT</Address1>
      <Address2>RT / RW 003 / 016 . </Address2>
      <Country>Indonesia</Country>
      <State/>
      <City>Taman Cimanggu Bogor</City>
      <Postcode>16163</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>david.alan.baker@gmail.com</Email>
    <Phone>
      <Home>628129809896</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Dina Susanti </AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Daughter</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4270829026097896</CreditcardNumber>
      <NameonCreditcard>David A Baker</NameonCreditcard>
      <CreditcardExpirationMonth>8</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2018</CreditcardExpirationYear>
      <CreditcardAmount>208.8</CreditcardAmount>
      <CreditcardCodeNumber>916</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
927d1ea7
ARS-02-0036705
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0036705</PolicyNumber><UserName>927d1ea7</UserName><Password>927d1ea7</Password></PolicyDetails></RegistrationRes>