Get a Quotation

Please email me the info:

For the MEDICAL CARD or Others

1. Full Name

2. D.O.B (Date of Birth)

3. Status: Single/Married/Others

4. No. of Children (if any)

5. Smoker or Non-Smoker

6. Occupation & Nature of Occupation

7. Location ( Could be Town or City) e.g: Ipoh, etc....

8. Your Annual Income

9. Previous Medical History (if any)

10. Contact Number (Hand Phone, Home, Office)

11. Email

E-mail to me at cccardsdirect@gmail.com
Thank You..!