174.129.122.238
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>11/01/2016</StartDate>
  <EndDate>11/02/2016</EndDate>
  <DestinationPlan>India</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Judith</Firstname>
    <Middlename/>
    <Lastname>Bokeloh</Lastname>
    <Age>64</Age>
    <Dob>10/23/1952</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>11/01/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>van Diemenstraat 89</Address1>
      <Address2/>
      <Country>Netherlands</Country>
      <State/>
      <City>Den Haag</City>
      <Postcode>2518 TX</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>wsjleonard@gmail.com</Email>
    <Phone>
      <Home>31627569363</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>William Leonard</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4400668848638815</CreditcardNumber>
      <NameonCreditcard>William S Leonard</NameonCreditcard>
      <CreditcardExpirationMonth>5</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>22.5</CreditcardAmount>
      <CreditcardCodeNumber>377</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
9b7a076f
ARS-02-0030344
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0030344</PolicyNumber><UserName>9b7a076f</UserName><Password>9b7a076f</Password></PolicyDetails></RegistrationRes>