184.72.211.106
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>2500</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>10/13/2016</StartDate>
  <EndDate>04/09/2017</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Keshab</Firstname>
    <Middlename>R</Middlename>
    <Lastname>Shivakoti</Lastname>
    <Age>62</Age>
    <Dob>07/01/1954</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>10/13/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>190 B.P. Marga, Kalanki-14</Address1>
      <Address2/>
      <Country>Nepal</Country>
      <State/>
      <City>Kathmandu</City>
      <Postcode>NA</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>shivakotimikesh@gmail.com</Email>
    <Phone>
      <Home>18705625220</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Mikesh Shivakoti</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Child</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>372547878791003</CreditcardNumber>
      <NameonCreditcard>Mikesh R Shivakoti</NameonCreditcard>
      <CreditcardExpirationMonth>6</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>563.85</CreditcardAmount>
      <CreditcardCodeNumber>9581</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
c11dc9c3
ARS-02-0029972
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0029972</PolicyNumber><UserName>c11dc9c3</UserName><Password>c11dc9c3</Password></PolicyDetails></RegistrationRes>