{"id":464,"date":"2025-09-14T15:19:30","date_gmt":"2025-09-14T15:19:30","guid":{"rendered":"https:\/\/social.binamna.com\/?page_id=464"},"modified":"2026-01-28T12:42:16","modified_gmt":"2026-01-28T12:42:16","slug":"parental-care-plus-buy-now","status":"publish","type":"page","link":"https:\/\/jubileegeneral.com.pk\/ammi-abbu-kayliye-jubilee\/parental-care-plus-buy-now\/","title":{"rendered":"Parental Care Plus &#8211; Buy Now"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"464\" class=\"elementor elementor-464\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9e57e2c e-con-full e-flex e-con e-parent\" data-id=\"9e57e2c\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;video&quot;,&quot;background_video_link&quot;:&quot;\\\/wp-content\\\/uploads\\\/2025\\\/10\\\/FinalVideoJGI.mp4&quot;,&quot;background_play_on_mobile&quot;:&quot;yes&quot;}\">\n\t\t<div class=\"elementor-background-video-container\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<video class=\"elementor-background-video-hosted\" autoplay muted playsinline loop><\/video>\n\t\t\t\t\t<\/div><div class=\"elementor-element elementor-element-366beca e-con-full urFlex e-flex e-con e-child\" data-id=\"366beca\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-09758a9 e-con-full e-flex e-con e-child\" data-id=\"09758a9\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d78363d elementor-invisible elementor-widget elementor-widget-image\" data-id=\"d78363d\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInDown&quot;}\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/jubileegeneral.com.pk\/\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"161\" height=\"91\" src=\"https:\/\/jubileegeneral.com.pk\/ammi-abbu-kayliye-jubilee\/wp-content\/uploads\/2025\/09\/Group-53.png\" class=\"attachment-large size-large wp-image-386\" alt=\"\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-f3b8f0f e-con-full rtlbtn_Container e-flex e-con e-child\" data-id=\"f3b8f0f\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-03ae239 elementor-align-justify elementor-mobile-align-justify elementor-widget__width-initial urRight elementor-widget elementor-widget-button\" data-id=\"03ae239\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-grow\" href=\"https:\/\/jubileegeneral.com.pk\/ammi-abbu-kayliye-jubilee\/parental-care-plus-buy-now\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">BUY NOW<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-71a5390 elementor-align-justify elementor-mobile-align-justify elementor-widget__width-initial urRight elementor-widget elementor-widget-button\" data-id=\"71a5390\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-grow\" href=\"#popmake-450\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">CALL ME<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-7ab4c03 e-flex e-con-boxed e-con e-child\" data-id=\"7ab4c03\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-987daf8 e-con-full e-flex e-con e-child\" data-id=\"987daf8\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e6f1d28 elementor-widget elementor-widget-shortcode\" data-id=\"e6f1d28\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><script type=\"text\/javascript\">var 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var(--gform-theme-control-button-font-size-md);--gform-theme-control-button-padding-inline: var(--gform-theme-control-button-padding-inline-md);--gform-theme-control-button-size: var(--gform-theme-control-button-size-md);--gform-theme-control-button-border-color-secondary: #686e77;--gform-theme-control-file-button-background-color-hover: #EBEBEB;--gform-theme-field-page-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><div id='gf_4' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_4'  action='\/ammi-abbu-kayliye-jubilee\/wp-json\/wp\/v2\/pages\/464#gf_4' data-formid='4' novalidate> \r\n <input type='hidden' class='gforms-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/>\n        <div id='gf_progressbar_wrapper_4' class='gf_progressbar_wrapper'>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>3<\/span> - Personal Information\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_custom' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_custom percentbar_33' style='width:33%; color:#000; background-color:#BA0C2F;'><span>33%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_4_1' class='gform_page myStepBar' data-js='page-field-id-1' >\n                                    <div class='gform_page_fields'><div id='gform_fields_4' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_4_66\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_66\"><\/div><div id=\"field_4_44\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_44\"><\/div><div id=\"field_4_14\"  class=\"gfield gfield--type-select gfield--width-quarter field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_14\"><label class='gfield_label gform-field-label' for='input_4_14' >I would like to cover<\/label><div class='ginput_container ginput_container_select'><select name='input_14' id='input_4_14' class='large gfield_select'     aria-invalid=\"false\" ><option value='myself' >Myself<\/option><option value='father' >My Father<\/option><option value='mother' >My Mother<\/option><option value='uncle' >Uncle<\/option><option value='aunt' >Aunt<\/option><\/select><\/div><\/div><div id=\"field_4_1\"  class=\"gfield gfield--type-text gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_1\"><label class='gfield_label gform-field-label' for='input_4_1' >Full Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_4_1' type='text' value='' class='large'    placeholder='Full Name' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_3\"  class=\"gfield gfield--type-text gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_3\"><label class='gfield_label gform-field-label' for='input_4_3' >Phone Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_4_3' type='text' value='03' class='large'    placeholder='Phone Number' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_4\"  class=\"gfield gfield--type-email gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_4\"><label class='gfield_label gform-field-label' for='input_4_4' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_4_4' type='email' value='' class='large'   placeholder='Email' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_4_12\"  class=\"gfield gfield--type-select gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_12\"><label class='gfield_label gform-field-label' for='input_4_12' >Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_4_12' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Male' >Male<\/option><option value='Female' >Female<\/option><\/select><\/div><\/div><div id=\"field_4_49\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_49\"><label class='gfield_label gform-field-label' for='input_4_49' >Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_49' id='input_4_49' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon'   placeholder='__\/__\/____' aria-describedby=\"input_4_49_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_4_49_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_4_49' class='gform_hidden' value='https:\/\/jubileegeneral.com.pk\/ammi-abbu-kayliye-jubilee\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_4_7\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_7\"><label class='gfield_label gform-field-label' for='input_4_7' >Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_7' id='input_4_7' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon'   placeholder='__\/__\/____' aria-describedby=\"input_4_7_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_4_7_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_4_7' class='gform_hidden' value='https:\/\/jubileegeneral.com.pk\/ammi-abbu-kayliye-jubilee\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_4_9\"  class=\"gfield gfield--type-text gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_9\"><label class='gfield_label gform-field-label' for='input_4_9' >CNIC\/NICOP<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_4_9' type='text' value='' class='large'    placeholder='_____-_______-_' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_8\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_8\"><label class='gfield_label gform-field-label' for='input_4_8' >CNIC\/NICOP Issue Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_8' id='input_4_8' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon'   placeholder='__\/__\/____' aria-describedby=\"input_4_8_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_4_8_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_4_8' class='gform_hidden' value='https:\/\/jubileegeneral.com.pk\/ammi-abbu-kayliye-jubilee\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_4_13\"  class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_13\"><label class='gfield_label gform-field-label' for='input_4_13' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_4_13' type='text' value='' class='large'    placeholder='Address' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_50\"  class=\"gfield gfield--type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_50\"><label class='gfield_label gform-field-label' for='input_4_50' >Product Type<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_50' id='input_4_50' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='47' selected='selected'>Conventional<\/option><option value='45' >Takaful<\/option><\/select><\/div><\/div><div id=\"field_4_15\"  class=\"gfield gfield--type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_15\"><label class='gfield_label gform-field-label' for='input_4_15' >Plan Type<\/label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_4_15' class='large gfield_select'     aria-invalid=\"false\" ><option value='Platinum' selected='selected'>Platinum<\/option><option value='Gold' >Gold<\/option><option value='Silver' >Silver<\/option><\/select><\/div><\/div><div id=\"field_4_16\"  class=\"gfield gfield--type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_16\"><label class='gfield_label gform-field-label' for='input_4_16' >Total Health Coverage<\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_4_16' type='text' value='PKR 500,000' class='large'    placeholder='PKR 250,000'  aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_17\"  class=\"gfield gfield--type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_17\"><label class='gfield_label gform-field-label' for='input_4_17' >Annual OPD Limit<\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_4_17' type='text' value='PKR 40,000' class='large'    placeholder='PKR 20,000'  aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_18\"  class=\"gfield gfield--type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_18\"><label class='gfield_label gform-field-label' for='input_4_18' >Premium<\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_4_18' type='text' value='PKR 87,000' class='large'    placeholder='PKR 44,000'  aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_56\"  class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_56\"><div class='ginput_container ginput_container_text'><input name='input_56' id='input_4_56' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_4_30\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_30\"><p id=\"familyMember\"><\/p>\n<\/div><div id=\"field_4_31\"  class=\"gfield gfield--type-text gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_31\"><label class='gfield_label gform-field-label' for='input_4_31' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_4_31' type='text' value='' class='large'    placeholder='Name' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_33\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_33\"><label class='gfield_label gform-field-label' for='input_4_33' >Date  Of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_33' id='input_4_33' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon'   placeholder='__\/__\/____' aria-describedby=\"input_4_33_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_4_33_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_4_33' class='gform_hidden' value='https:\/\/jubileegeneral.com.pk\/ammi-abbu-kayliye-jubilee\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_4_37\"  class=\"gfield gfield--type-text gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_37\"><label class='gfield_label gform-field-label' for='input_4_37' >CNIC\/NICOP<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_4_37' type='text' value='' class='large'    placeholder='_____-_______-_' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_35\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_35\"><label class='gfield_label gform-field-label' for='input_4_35' >CNIC\/NICOP Issue Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_35' id='input_4_35' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon'   placeholder='__\/__\/____' aria-describedby=\"input_4_35_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_4_35_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_4_35' class='gform_hidden' value='https:\/\/jubileegeneral.com.pk\/ammi-abbu-kayliye-jubilee\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_4_38\"  class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_38\"><label class='gfield_label gform-field-label' for='input_4_38' >Mobile Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_38' id='input_4_38' type='text' value='' class='large'    placeholder='Mobile Number' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_32\"  class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_32\"><label class='gfield_label gform-field-label' for='input_4_32' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_32' id='input_4_32' type='text' value='' class='large'    placeholder='Address' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div class=\"spacer gfield\" style=\"grid-column: span 4;\"><\/div><div id=\"field_4_28\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_hidden\"  data-js-reload=\"field_4_28\"><script>\ndocument.addEventListener('DOMContentLoaded', function () {\n\n \/\/ ====== MAKE FIELDS READ-ONLY ======\n  ['input_4_16', 'input_4_17', 'input_4_18'].forEach(id => {\n    const el = document.getElementById(id);\n    if (el) el.readOnly = true;\n  });\n\n  \/\/ ====== PLAN SELECTION (Platinum \/ Gold \/ Silver) ======\n  const planDropdown = document.getElementById(\"input_4_15\");\n\n  if (planDropdown) {\n    planDropdown.addEventListener(\"change\", function() {\n      const selectedValue = this.value;\n      let input16Value = \"\";\n      let input17Value = \"\";\n      let input18Value = \"\";\n\n      if (selectedValue === \"Platinum\") {\n        input16Value = \"PKR 500,000\";\n        input17Value = \"PKR 40,000\";\n        input18Value = \"PKR 87,000\";\n      } else if (selectedValue === \"Gold\") {\n        input16Value = \"PKR 250,000\";\n        input17Value = \"PKR 20,000\";\n        input18Value = \"PKR 44,000\";\n      } else if (selectedValue === \"Silver\") {\n        input16Value = \"PKR 100,000\";\n        input17Value = \"PKR 10,000\";\n        input18Value = \"PKR 20,000\";\n      }\n\n      document.getElementById(\"input_4_16\").value = input16Value;\n      document.getElementById(\"input_4_17\").value = input17Value;\n      document.getElementById(\"input_4_18\").value = input18Value;\n    });\n  }\n\n});\n\n\ndocument.addEventListener(\"DOMContentLoaded\", function () {\n  const familyDropdown = document.getElementById('input_4_14');\n  const familyText = document.getElementById('familyMember');\n\n  if (familyDropdown && familyText) {\n    familyDropdown.addEventListener('change', function () {\n      let selected = this.value;\n      selected = selected.trim().toLowerCase(); \/\/ remove extra spaces + case normalize\n      \n      const messages = {\n        myself: \"Myself\",\n        father: \"Share Your Father`s Detail\",\n        mother: \"Share Your Mother`s Detail\",\n        uncle: \"Share Your Uncle`s Detail\",\n        aunt: \"Share Your Aunt`s Detail\"\n      };\n\n      const message = messages[selected] || '';\n      familyText.textContent = message;\n    });\n  }\n});\n\n\n<\/script>\n<script>\njQuery(document).on('gform_post_render', function() {\n  const fieldDiv = document.getElementById('field_4_33');\n\n  \/\/ Add warning element if not already added\n  if (fieldDiv && !document.getElementById('ageWarning')) {\n    const warning = document.createElement('p');\n    warning.id = 'ageWarning';\n    warning.style.color = 'red';\n    warning.style.marginTop = '5px';\n    fieldDiv.appendChild(warning);\n  }\n\n  const dateInput = jQuery('#input_4_33');\n\n  function validateAge(value) {\n    const birthDate = new Date(value);\n    const warning = document.getElementById('ageWarning');\n    if (!warning) return;\n\n    if (isNaN(birthDate)) {\n      warning.textContent = '';\n      return;\n    }\n\n    const today = new Date();\n    let age = today.getFullYear() - birthDate.getFullYear();\n    const m = today.getMonth() - birthDate.getMonth();\n    if (m < 0 || (m === 0 && today.getDate() < birthDate.getDate())) {\n      age--;\n    }\n\n    if (age < 45) {\n      warning.textContent = 'Please enter a date indicating age at least 45 years.';\n    } else {\n      warning.textContent = '';\n    }\n  }\n\n  \/\/ Handle manual typing\n  dateInput.on('change', function() {\n    validateAge(this.value);\n  });\n\n  \/\/ Handle datepicker selection\n  if (dateInput.hasClass('hasDatepicker')) {\n    dateInput.datepicker('option', 'onSelect', function(dateText) {\n      validateAge(dateText);\n    });\n  }\n});\n\n\n\n\n\n\ndocument.addEventListener('change', function() {\n    const dropdown1 = document.getElementById('input_4_50'); \/\/ First dropdown\n    const dropdown2 = document.getElementById('input_4_15'); \/\/ Second dropdown\n    const targetInput = document.getElementById('input_4_56'); \/\/ Target field\n\n    const val1 = dropdown1.value;\n    const val2 = dropdown2.value.toLowerCase();\n\n    if (val1 === '47') {\n        if (val2 === 'platinum') targetInput.value = 611;\n        else if (val2 === 'gold') targetInput.value = 612;\n        else if (val2 === 'silver') targetInput.value = 613;\n    } else if (val1 === '45') {\n        if (val2 === 'platinum') targetInput.value = 601;\n        else if (val2 === 'gold') targetInput.value = 602;\n        else if (val2 === 'silver') targetInput.value = 603;\n    } else {\n        targetInput.value = ''; \/\/ clear if no match\n    }\n});\n\n<\/script>\n\n<script>\njQuery(document).ready(function ($) {\n  \/\/ When dropdown value changes\n  $('#input_4_50').on('change', function () {\n    const selectedValue = $(this).val();\n\n    \/\/ Find the label for #input_4_18\n    const $label = $('label[for=\"input_4_18\"]');\n\n    if (selectedValue === '45') {\n      \/\/ If user selects Takaful\n      $label.text('Contribution');\n    } else {\n      \/\/ If user selects Conventional (47)\n      $label.text('Premium');\n    }\n  });\n\n  \/\/ Run once on page load to set initial label correctly\n  $('#input_4_50').trigger('change');\n});\n<\/script>\n<\/div><div id=\"field_4_19\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_19\"><span style=\"color:#BA0C2F; font-size:14px;\">Disclaimer:\u00a0Never share your OTP, card details, or payment information with anyone. Jubilee General Insurance will never request this information via phone, email, or any other channel.<\/span><\/div><div id=\"field_4_72\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_72\"><span style=\"color:#BA0C2F; font-size:14px;\">Disclaimer:\u00a0Never share your OTP, card details, or payment information with anyone. Jubilee General Takaful will never request this information via phone, email, or any other channel.<\/span><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_4_5' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_4\").val(\"2\");  jQuery(\"#gform_4\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_4\").val(\"2\");  jQuery(\"#gform_4\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_4_2' class='gform_page' data-js='page-field-id-5' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_4_2' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_4_73\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_73\"><div class=\"Q_title\"><strong class=\"Q_Nums\">1. <\/strong>Do you have any existing medical conditions that require ongoing treatment, medication, or regular doctor visits<span class=\"q_font\">?<\/span> For example, diabetes, heart issues, high blood pressure or any other long-term condition (5 years or more)<span class=\"q_font\">?<\/span><\/div><\/div><div id=\"field_4_86\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_86\"><div class=\"Q_title\"><strong class=\"Q_Nums\">1. <\/strong>Does the participant have any existing medical conditions that require ongoing treatment, medication, or regular doctor visits<span class=\"q_font\">?<\/span> For example, diabetes, heart issues, high blood pressure or any other long-term condition (5 years or more)<span class=\"q_font\">?<\/span><\/div><\/div><div id=\"field_4_80\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_80\"><div class=\"Q_title\"><strong class=\"Q_Nums\">1. <\/strong>Does the insured have any existing medical conditions that require ongoing treatment, medication, or regular doctor visits<span class=\"q_font\">?<\/span> For example, diabetes, heart issues, high blood pressure or any other long-term condition (5 years or more)<span class=\"q_font\">?<\/span><\/div><\/div><fieldset id=\"field_4_20\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_4_20\"><legend class='gfield_label gform-field-label'  >1. Does the participant has any existing medical conditions that require ongoing treatment, medication, or regular doctor visits? For example, diabetes, heart issues, high blood pressure or any other long-term condition (5 years or more)?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_20'>\n\t\t\t<div class='gchoice gchoice_4_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='Yes'  id='choice_4_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_20_0' id='label_4_20_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='No'  id='choice_4_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_20_1' id='label_4_20_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_74\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_74\"><div class=\"Q_title\"><strong class=\"Q_Nums\">2. <\/strong>In the past 2 years, have you  been admitted to a hospital, undergone major surgery or been diagnosed with any serious illness<span class=\"q_font\">?<\/span><\/div><\/div><div id=\"field_4_87\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_87\"><div class=\"Q_title\"><strong class=\"Q_Nums\">2. <\/strong>In the past 2 years, has the participant been admitted to a hospital, undergone major surgery or been diagnosed with any serious illness<span class=\"q_font\">?<\/span><\/div><\/div><div id=\"field_4_81\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_81\"><div class=\"Q_title\"><strong class=\"Q_Nums\">2. <\/strong>In the past 2 years, has the insured been admitted to a hospital, undergone major surgery or been diagnosed with any serious illness<span class=\"q_font\">?<\/span><\/div><\/div><fieldset id=\"field_4_21\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_4_21\"><legend class='gfield_label gform-field-label'  >2. In the past 2 years, has the participant been admitted to a hospital, undergone major surgery or been diagnosed with any serious illness?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_21'>\n\t\t\t<div class='gchoice gchoice_4_21_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Yes'  id='choice_4_21_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_21_0' id='label_4_21_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_21_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='No'  id='choice_4_21_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_21_1' id='label_4_21_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_75\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_75\"><div class=\"Q_title\"><strong class=\"Q_Nums\">3. <\/strong>Do you need help with any daily activities like walking, dressing, personal care or do you face any difficulty doing these on your own<span class=\"q_font\">?<\/span><\/div><\/div><div id=\"field_4_88\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_88\"><div class=\"Q_title\"><strong class=\"Q_Nums\">3. <\/strong>Does the participant help with any daily activities like walking, dressing, personal care or do you face any difficulty doing these on your own<span class=\"q_font\">?<\/span><\/div><\/div><div id=\"field_4_82\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_82\"><div class=\"Q_title\"><strong class=\"Q_Nums\">3. <\/strong>Does the insured need help with any daily activities like walking, dressing, personal care or face any difficulty doing these on his\/her own<span class=\"q_font\">?<\/span><\/div><\/div><fieldset id=\"field_4_22\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_4_22\"><legend class='gfield_label gform-field-label'  >3. Does the participant help with any daily activities like walking, dressing, personal care or do you face any difficulty doing these on your own?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_22'>\n\t\t\t<div class='gchoice gchoice_4_22_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='Yes'  id='choice_4_22_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_22_0' id='label_4_22_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_22_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='No'  id='choice_4_22_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_22_1' id='label_4_22_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_76\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_76\"><div class=\"Q_title\"><strong class=\"Q_Nums\">4. <\/strong>Are you currently waiting for any test results, medical treatments or have any upcoming surgeries planned<span class=\"q_font\">?<\/span><\/div><\/div><div id=\"field_4_89\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_89\"><div class=\"Q_title\"><strong class=\"Q_Nums\">4. <\/strong>Is the participant currently waiting for any test results, medical treatments or have any upcoming surgeries planned<span class=\"q_font\">?<\/span><\/div><\/div><div id=\"field_4_83\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_83\"><div class=\"Q_title\"><strong class=\"Q_Nums\">4. <\/strong>Is the insured currently waiting for any test results, medical treatments or have any upcoming surgeries planned<span class=\"q_font\">?<\/span><\/div><\/div><fieldset id=\"field_4_23\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_4_23\"><legend class='gfield_label gform-field-label'  >4. Is the participant currently waiting for any test results, medical treatments or have any upcoming surgeries planned?\u2028<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_23'>\n\t\t\t<div class='gchoice gchoice_4_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Yes'  id='choice_4_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_23_0' id='label_4_23_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='No'  id='choice_4_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_23_1' id='label_4_23_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_77\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_77\"><div class=\"Q_title\"><strong class=\"Q_Nums\">5. <\/strong>Have you ever been diagnosed with or treated for any condition related to your heart, lungs, kidneys or any type of cancer<span class=\"q_font\">?<\/span><\/div><\/div><div id=\"field_4_90\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_90\"><div class=\"Q_title\"><strong class=\"Q_Nums\">5. <\/strong>Has the participant ever been diagnosed with or treated for any condition related to his\/her heart, lungs, kidneys or any type of cancer<span class=\"q_font\">?<\/span><\/div><\/div><div id=\"field_4_84\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_84\"><div class=\"Q_title\"><strong class=\"Q_Nums\">5. <\/strong>Has the insured ever been diagnosed with or treated for any condition related to his\/her heart, lungs, kidneys or any type of cancer<span class=\"q_font\">?<\/span><\/div><\/div><fieldset id=\"field_4_24\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_4_24\"><legend class='gfield_label gform-field-label'  >5. Has the participant ever been diagnosed with or treated for any condition related to your heart, lungs, kidneys or any type of cancer?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_24'>\n\t\t\t<div class='gchoice gchoice_4_24_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='Yes'  id='choice_4_24_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_24_0' id='label_4_24_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_24_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='No'  id='choice_4_24_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_24_1' id='label_4_24_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_26\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_26\"><span style=\"color:#BA0C2F; font-size:14px;\">* Participant: The person who will be covered under this plan<\/span><\/div><div id=\"field_4_85\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_85\"><span style=\"color:#BA0C2F; font-size:14px;\">* Insured: The person who will be covered under this plan<\/span><\/div><fieldset id=\"field_4_25\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_4_25\"><legend class='gfield_label gform-field-label gfield_label_before_complex'  >I declare that I have truthfully answered the health-related questions to the best of my knowledge and I understand that any incorrect or incomplete information may affect the validity of my insurance coverage or future claims.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_4_25'><div class='gchoice gchoice_4_25_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.1' type='checkbox'  value='I declare that I have truthfully answered the health-related questions to the best of my knowledge and I understand that any incorrect or incomplete information may affect the validity of my insurance coverage or future claims.'  id='choice_4_25_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_25_1' id='label_4_25_1' class='gform-field-label gform-field-label--type-inline'>I declare that I have truthfully answered the health-related questions to the best of my knowledge and I understand that any incorrect or incomplete information may affect the validity of my insurance coverage or future claims.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_94\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_4_94\"><legend class='gfield_label gform-field-label gfield_label_before_complex'  >I declare that I have truthfully answered the health-related questions to the best of my knowledge and I understand that any incorrect or incomplete information may affect the validity of my insurance coverage or future claims.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_4_94'><div class='gchoice gchoice_4_94_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_94.1' type='checkbox'  value='I declare that I have truthfully answered the health-related questions to the best of my knowledge and I understand that any incorrect or incomplete information may affect the validity of my takaful cover or future claims.'  id='choice_4_94_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_94_1' id='label_4_94_1' class='gform-field-label gform-field-label--type-inline'>I declare that I have truthfully answered the health-related questions to the best of my knowledge and I understand that any incorrect or incomplete information may affect the validity of my takaful cover or future claims.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_4_6' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Back'  onclick='jQuery(\"#gform_target_page_number_4\").val(\"1\");  jQuery(\"#gform_4\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_4\").val(\"1\");  jQuery(\"#gform_4\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_4_6' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_4\").val(\"3\");  jQuery(\"#gform_4\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_4\").val(\"3\");  jQuery(\"#gform_4\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_4_3' class='gform_page' data-js='page-field-id-6' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_4_3' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_4_27\"  class=\"gfield gfield--type-text gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_27\"><label class='gfield_label gform-field-label' for='input_4_27' >Full Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_4_27' type='text' value='' class='large'    placeholder='Full Name' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_39\"  class=\"gfield gfield--type-text gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_39\"><label class='gfield_label gform-field-label' for='input_4_39' >Mobile Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_39' id='input_4_39' type='text' value='' class='large'    placeholder='Mobile Number' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_40\"  class=\"gfield gfield--type-email gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_40\"><label class='gfield_label gform-field-label' for='input_4_40' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_40' id='input_4_40' type='email' value='' class='large'   placeholder='Email Address' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_4_43\"  class=\"gfield gfield--type-text gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_43\"><label class='gfield_label gform-field-label' for='input_4_43' >Billing\/Shipping Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_4_43' type='text' value='' class='large'    placeholder='Billing\/Shipping Address' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_41\"  class=\"gfield gfield--type-select gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_41\"><label class='gfield_label gform-field-label' for='input_4_41' >Referred By<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_41' id='input_4_41' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Friend' >Friend<\/option><option value='Search Engine' >Search Engine<\/option><option value='Newspaper\/Magazine' >Newspaper\/Magazine<\/option><option value='Facebook' >Facebook<\/option><option value='Radio' >Radio<\/option><option value='TV' >TV<\/option><option value='Offline Event' >Offline Event<\/option><option value='Jubilee brand rep.' >Jubilee brand rep.<\/option><option value='Branded SMS' >Branded SMS<\/option><option value='Email' >Email<\/option><\/select><\/div><\/div><div id=\"field_4_53\"  class=\"gfield gfield--type-select gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_53\"><label class='gfield_label gform-field-label' for='input_4_53' >Branch<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_53' id='input_4_53' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Head office' >Head office<\/option><option value='Corporate Division' >Corporate Division<\/option><option value='Medical' >Medical<\/option><option value='Oil' >Oil<\/option><option value='Agri' >Agri<\/option><option value='Live Stock' >Live Stock<\/option><option value='Reinsurance Branch' >Reinsurance Branch<\/option><option value='Retail Business Division' >Retail Business Division<\/option><option value='Micro Insurance Business Division' >Micro Insurance Business Division<\/option><option value='Plaza Branch' >Plaza Branch<\/option><option value='Shahrah-e-Faisal Branch' >Shahrah-e-Faisal Branch<\/option><option value='Hyderabad Branch' >Hyderabad Branch<\/option><option value='Sukkur branch' >Sukkur branch<\/option><option value='Business &amp; Finance Centre Branch' >Business &amp; Finance Centre Branch<\/option><option value='Site' >Site<\/option><option value='Jodia Bazar Branch' >Jodia Bazar Branch<\/option><option value='Saddar Branch' >Saddar Branch<\/option><option value='New Unit' >New Unit<\/option><option value='KEPZ Branch' >KEPZ Branch<\/option><option value='Tariq Road Branch' >Tariq Road Branch<\/option><option value='Clifton Branch' >Clifton Branch<\/option><option value='DHA Branch' >DHA Branch<\/option><option value='Lahore Zone' >Lahore Zone<\/option><option value='Sales Unit - I' >Sales Unit - I<\/option><option value='Sales Unit - II' >Sales Unit - II<\/option><option value='Sales Unit - III' >Sales Unit - III<\/option><option value='Liberty MKT' >Liberty MKT<\/option><option value='Sales Unit - V' >Sales Unit - V<\/option><option value='Mall Mansion' >Mall Mansion<\/option><option value='Faisalabad Branch' >Faisalabad Branch<\/option><option value='Sailkot' >Sailkot<\/option><option value='Bank Square Branch' >Bank Square Branch<\/option><option value='Lahore Eng. Infrastructure Branch' >Lahore Eng. Infrastructure Branch<\/option><option value='Retail Business Division LZO' >Retail Business Division LZO<\/option><option value='Multan Zone' >Multan Zone<\/option><option value='Multan (Main Branch)' >Multan (Main Branch)<\/option><option value='Rahimyar Khan Branch' >Rahimyar Khan Branch<\/option><option value='Sahiwal Branch' >Sahiwal Branch<\/option><option value='Bahawalpur Branch' >Bahawalpur Branch<\/option><option value='Bahawalnagar Branch' >Bahawalnagar Branch<\/option><option value='Islamabad Branch' >Islamabad Branch<\/option><option value='Margalla Branch' >Margalla Branch<\/option><option value='Peshawar Branch' >Peshawar Branch<\/option><option value='Commercial Unit - I' >Commercial Unit - I<\/option><option value='Commercial Unit - II' >Commercial Unit - II<\/option><option value='Commercial Unit - III' >Commercial Unit - III<\/option><option value='EIIB' >EIIB<\/option><option value='Centralized CU Zone' >Centralized CU Zone<\/option><option value='IDEVAFFILIATEBRANCH' >IDEVAFFILIATEBRANCH<\/option><option value='Call Center' >Call Center<\/option><option value='Bancassurance' >Bancassurance<\/option><option value='E Branch' >E Branch<\/option><\/select><\/div><\/div><div id=\"field_4_54\"  class=\"gfield gfield--type-text gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_54\"><label class='gfield_label gform-field-label' for='input_4_54' >Agent Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_54' id='input_4_54' type='text' value='' class='large'    placeholder='Agent Name' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_42\"  class=\"gfield gfield--type-select gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_42\"><label class='gfield_label gform-field-label' for='input_4_42' >City<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_42' id='input_4_42' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Karachi' >Karachi<\/option><option value='Lahore' >Lahore<\/option><option value='Islamabad' >Islamabad<\/option><option value='Rawalpindi' >Rawalpindi<\/option><option value='Peshawar' >Peshawar<\/option><option value='Multan' >Multan<\/option><option value='Quetta' >Quetta<\/option><option value='Faisalabad' >Faisalabad<\/option><option value='Abbottabad' >Abbottabad<\/option><option value='Abdul Hakeem' >Abdul Hakeem<\/option><option value='Ahmedpur East' >Ahmedpur East<\/option><option value='Ahmedpur Lamma' >Ahmedpur Lamma<\/option><option value='Alipur' >Alipur<\/option><option value='Alipur chatta' >Alipur chatta<\/option><option value='Arifwala' >Arifwala<\/option><option value='Attock' >Attock<\/option><option value='BASTI SHOREKOT' >BASTI SHOREKOT<\/option><option value='Badin' >Badin<\/option><option value='Bahawalpur' >Bahawalpur<\/option><option value='Bahwalnagar' >Bahwalnagar<\/option><option value='Basirpur' >Basirpur<\/option><option value='Bhai Pheru' >Bhai Pheru<\/option><option value='Bhakkar' >Bhakkar<\/option><option value='Bhikky' >Bhikky<\/option><option value='Bhimber' >Bhimber<\/option><option value='Burewala' >Burewala<\/option><option value='Chakwal' >Chakwal<\/option><option value='Charsadda' >Charsadda<\/option><option value='Chashma' >Chashma<\/option><option value='Chawinda' >Chawinda<\/option><option value='Chichawatni' >Chichawatni<\/option><option value='Chiniot' >Chiniot<\/option><option value='Chishtian' >Chishtian<\/option><option value='Dadu' >Dadu<\/option><option value='Dadyal AK' >Dadyal AK<\/option><option value='Daharki' >Daharki<\/option><option value='Daska' >Daska<\/option><option value='Daud Khel' >Daud Khel<\/option><option value='Daulatpur' >Daulatpur<\/option><option value='Depalpur' >Depalpur<\/option><option value='Dera Allah Yar' >Dera Allah Yar<\/option><option value='Dera Ghazi Khan' >Dera Ghazi Khan<\/option><option value='Dera Ismail Khan' >Dera Ismail Khan<\/option><option value='Dera Murad Jamali' >Dera Murad Jamali<\/option><option value='Digri' >Digri<\/option><option value='Dina' >Dina<\/option><option value='Dinga' >Dinga<\/option><option value='Donga Bonga' >Donga Bonga<\/option><option value='Dunia pur' >Dunia pur<\/option><option value='Esa Khel' >Esa Khel<\/option><option value='Faqirwali' >Faqirwali<\/option><option value='Fateh Jang' >Fateh Jang<\/option><option value='Ferozwatowan' >Ferozwatowan<\/option><option value='Fort Abbass' >Fort Abbass<\/option><option value='Gadoon Amazai' >Gadoon Amazai<\/option><option value='Gaggo Mandi' >Gaggo Mandi<\/option><option value='Gakhar Mandi' >Gakhar Mandi<\/option><option value='Gambat' >Gambat<\/option><option value='Ghotki' >Ghotki<\/option><option value='Gojra' >Gojra<\/option><option value='Goth Machi' >Goth Machi<\/option><option value='Guddu' >Guddu<\/option><option value='Gujran khan' >Gujran khan<\/option><option value='Gujranwala' >Gujranwala<\/option><option value='Gujrat' >Gujrat<\/option><option value='HUB' >HUB<\/option><option value='Hafizabad' >Hafizabad<\/option><option value='Harappa' >Harappa<\/option><option value='Hari pur' >Hari pur<\/option><option value='Haroonabad' >Haroonabad<\/option><option value='Hasil pur' >Hasil pur<\/option><option value='Hassanabdal' >Hassanabdal<\/option><option value='Hattar' >Hattar<\/option><option value='Hattian' >Hattian<\/option><option value='Havali Lakhan' >Havali Lakhan<\/option><option value='HawiliaN' >HawiliaN<\/option><option value='Hazro' >Hazro<\/option><option value='Head Marala' >Head Marala<\/option><option value='Hujra Shah Mukeem' >Hujra Shah Mukeem<\/option><option value='Hyderabad' >Hyderabad<\/option><option value='Iskandarabad' >Iskandarabad<\/option><option value='Jacobabad' >Jacobabad<\/option><option value='Jahaniya' >Jahaniya<\/option><option value='Jalalpur Jattan' >Jalalpur Jattan<\/option><option value='Jalalpur pirwala' >Jalalpur pirwala<\/option><option value='Jampur' >Jampur<\/option><option value='Jamshoro' >Jamshoro<\/option><option value='Jand' >Jand<\/option><option value='Jaranwala' >Jaranwala<\/option><option value='Jatlaan' >Jatlaan<\/option><option value='Jatoi' >Jatoi<\/option><option value='Jauharabad' >Jauharabad<\/option><option value='Jhang' >Jhang<\/option><option value='Jhelum' >Jhelum<\/option><option value='Jin Pur' >Jin Pur<\/option><option value='K.N. Shah' >K.N. Shah<\/option><option value='KHYBER' >KHYBER<\/option><option value='Kabirwala' >Kabirwala<\/option><option value='Kahuta' >Kahuta<\/option><option value='Kala Bagh' >Kala Bagh<\/option><option value='Kala Shah Kaku' >Kala Shah Kaku<\/option><option value='Kallar Kahar' >Kallar Kahar<\/option><option value='Kallar Saddiyian' >Kallar Saddiyian<\/option><option value='Kamalia' >Kamalia<\/option><option value='Kameer' >Kameer<\/option><option value='Kamoke' >Kamoke<\/option><option value='Kamra' >Kamra<\/option><option value='Kandh Kot' >Kandh Kot<\/option><option value='Kandiaro' >Kandiaro<\/option><option value='Kashmore' >Kashmore<\/option><option value='Kasur' >Kasur<\/option><option value='Khairpur Mirs' >Khairpur Mirs<\/option><option value='Khan Bela' >Khan Bela<\/option><option value='Khan Pur' >Khan Pur<\/option><option value='Khanewal' >Khanewal<\/option><option value='Khanpur dem' >Khanpur dem<\/option><option value='Kharian' >Kharian<\/option><option value='Khewra' >Khewra<\/option><option value='Khurrianwala' >Khurrianwala<\/option><option value='Khushab' >Khushab<\/option><option value='Klaske' >Klaske<\/option><option value='Kohat' >Kohat<\/option><option value='Kot Addu' >Kot Addu<\/option><option value='Kot Momin' >Kot Momin<\/option><option value='Kotla Arab Ali Khan' >Kotla Arab Ali Khan<\/option><option value='Kotly AK' >Kotly AK<\/option><option value='Kotly Loharana' >Kotly Loharana<\/option><option value='Kunri' >Kunri<\/option><option value='Lala Musa' >Lala Musa<\/option><option value='Larkana' >Larkana<\/option><option value='Layya' >Layya<\/option><option value='Liaqat Pur' >Liaqat Pur<\/option><option value='Lodhran' >Lodhran<\/option><option value='MATIARI' >MATIARI<\/option><option value='Mainwali' >Mainwali<\/option><option value='Malikwal' >Malikwal<\/option><option value='Mandi Baha uddin' >Mandi Baha uddin<\/option><option value='Mandra' >Mandra<\/option><option value='Manga Mandi' >Manga Mandi<\/option><option value='Mangla' >Mangla<\/option><option value='Mansahra' >Mansahra<\/option><option value='Mardan' >Mardan<\/option><option value='Mehar' >Mehar<\/option><option value='Mehrabpur' >Mehrabpur<\/option><option value='Melsi' >Melsi<\/option><option value='Mian Channu' >Mian Channu<\/option><option value='Minchanaabad' >Minchanaabad<\/option><option value='Mirpur AK' >Mirpur AK<\/option><option value='Mirpur Khas' >Mirpur Khas<\/option><option value='Mirpur Mathelo' >Mirpur Mathelo<\/option><option value='Mithi' >Mithi<\/option><option value='Mitiari' >Mitiari<\/option><option value='Moro' >Moro<\/option><option value='Muridkay' >Muridkay<\/option><option value='Murree' >Murree<\/option><option value='Muzaffar gargh' >Muzaffar gargh<\/option><option value='Muzaffarabad' >Muzaffarabad<\/option><option value='Narowal' >Narowal<\/option><option value='Nawab Shah' >Nawab Shah<\/option><option value='Nooriabad' >Nooriabad<\/option><option value='Noshero Feroze' >Noshero Feroze<\/option><option value='Noudero' >Noudero<\/option><option value='Nowshera' >Nowshera<\/option><option value='Nowshera virka' >Nowshera virka<\/option><option value='Okara' >Okara<\/option><option value='Pak Pattan Sharif' >Pak Pattan Sharif<\/option><option value='Pani Aqil' >Pani Aqil<\/option><option value='Pasroor' >Pasroor<\/option><option value='Pattoke' >Pattoke<\/option><option value='Phalia' >Phalia<\/option><option value='Pind dadan Khan' >Pind dadan Khan<\/option><option value='Pindi Gheb' >Pindi Gheb<\/option><option value='Pindi bhattiya' >Pindi bhattiya<\/option><option value='Piplan' >Piplan<\/option><option value='Pir Mahal' >Pir Mahal<\/option><option value='Qamber Ali Khan' >Qamber Ali Khan<\/option><option value='Qila Deedar Singh' >Qila Deedar Singh<\/option><option value='Quaid abad' >Quaid abad<\/option><option value='Rabwah' >Rabwah<\/option><option value='Rahimyar Khan' >Rahimyar Khan<\/option><option value='Raiwind' >Raiwind<\/option><option value='Rajanpur' >Rajanpur<\/option><option value='Ranipur' >Ranipur<\/option><option value='Rato Dero' >Rato Dero<\/option><option value='Rawat' >Rawat<\/option><option value='Renala Khurd' >Renala Khurd<\/option><option value='Rohri' >Rohri<\/option><option value='SAMUNDRI' >SAMUNDRI<\/option><option value='SEKHAT' >SEKHAT<\/option><option value='SHOREKOT CANTT' >SHOREKOT CANTT<\/option><option value='Sadiq Abad' >Sadiq Abad<\/option><option value='Sahiwal' >Sahiwal<\/option><option value='Sakhi Sarwar' >Sakhi Sarwar<\/option><option value='Sambrial' >Sambrial<\/option><option value='Sanghar' >Sanghar<\/option><option value='Sangla Hills' >Sangla Hills<\/option><option value='Sanjarpur' >Sanjarpur<\/option><option value='Sara-e-alamgir' >Sara-e-alamgir<\/option><option value='Sargodha' >Sargodha<\/option><option value='Satiayana' >Satiayana<\/option><option value='Sawabi' >Sawabi<\/option><option value='Sehwan Sharif' >Sehwan Sharif<\/option><option value='Shahdadpur' >Shahdadpur<\/option><option value='Shahdara' >Shahdara<\/option><option value='Shahkot' >Shahkot<\/option><option value='Shahpur Saddar' >Shahpur Saddar<\/option><option value='Shakargarh' >Shakargarh<\/option><option value='Sheikhupura' >Sheikhupura<\/option><option value='Shikarpur' >Shikarpur<\/option><option value='Shorkot' >Shorkot<\/option><option value='Shuja Abad' >Shuja Abad<\/option><option value='Sialkot' >Sialkot<\/option><option value='Sillanwali' >Sillanwali<\/option><option value='Skrand' >Skrand<\/option><option value='Sohawa' >Sohawa<\/option><option value='Sukkar' >Sukkar<\/option><option value='Sumandari' >Sumandari<\/option><option value='Sundar' >Sundar<\/option><option value='Swat' >Swat<\/option><option value='Talagang' >Talagang<\/option><option value='Tandiliyawala' >Tandiliyawala<\/option><option value='Tando Adam' >Tando Adam<\/option><option value='Tando Allah Yar' >Tando Allah Yar<\/option><option value='Tando Jam' >Tando Jam<\/option><option value='Tando Muhammad Khan' >Tando Muhammad Khan<\/option><option value='Tarbela' >Tarbela<\/option><option value='Tatlay wali' >Tatlay wali<\/option><option value='Taunsa Sharif' >Taunsa Sharif<\/option><option value='Taxila' >Taxila<\/option><option value='Thatta' >Thatta<\/option><option value='Tobe Tek Singh' >Tobe Tek Singh<\/option><option value='Topi' >Topi<\/option><option value='Tranda Muhammad Pannah' >Tranda Muhammad Pannah<\/option><option value='Ubaro' >Ubaro<\/option><option value='Ugoke' >Ugoke<\/option><option value='Umer Kot' >Umer Kot<\/option><option value='Usta Muhammad' >Usta Muhammad<\/option><option value='Vehari' >Vehari<\/option><option value='Wah' >Wah<\/option><option value='Wahn Bachran' >Wahn Bachran<\/option><option value='Wazirabad' >Wazirabad<\/option><option value='Yazman' >Yazman<\/option><option value='Zafarwal' >Zafarwal<\/option><option value='Zahir peer' >Zahir peer<\/option><\/select><\/div><\/div><div id=\"field_4_91\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_91\"><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_4_51\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_4_51\"><legend class='gfield_label gform-field-label gfield_label_before_complex'  >Do you want to get this policy personalized with your\u00a0Ammi\/Abbu?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_4_51'><div class='gchoice gchoice_4_51_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.1' type='checkbox'  value='Do you want to get this policy personalized with your\u00a0Ammi\/Abbu?'  id='choice_4_51_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_51_1' id='label_4_51_1' class='gform-field-label gform-field-label--type-inline'>Do you want to get this policy personalized with your\u00a0Ammi\/Abbu<span class=\"q_font\">?<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_52\"  class=\"gfield gfield--type-fileupload gfield--width-full row-Group file-upload-group gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_52\"><label class='gfield_label gform-field-label' for='input_4_52' >Upload Your Image<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='4194304' \/><input name='input_52' id='input_4_52' type='file' class='large' aria-describedby=\"gfield_upload_rules_4_52\" onchange='javascript:gformValidateFileSize( this, 4194304 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_4_52'>Accepted file types: jpg, png, jpeg, , Max. file size: 4 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_4_52'><\/div><\/div><\/div><div id=\"field_4_68\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_68\"><div class=\"uploadStatus\"><\/div><\/div><div id=\"field_4_95\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_95\"><span style=\"color:#BA0C2F; font-size:14px;\">I warrant and represent that the attached photograph is mine and I own all rights, including copyright, in and to it, to the exclusion of all others. I grant Jubliee General Insurance the irrevocable right to reproduce, display, and distribute my image\/likeness, worldwide and in perpetuity, in any media format, with or without modification, and I waive any right to royalties or compensation.\u00a0I agree to indemnify and hold Jubilee General Insurance harmless against any and all claims, liabilities, damages, and expenses arising from any breach hereof.<\/span><\/div><div id=\"field_4_92\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_92\"><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_4_46\"  class=\"gfield gfield--type-text gfield--width-five-twelfths field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_46\"><label class='gfield_label gform-field-label' for='input_4_46' >PROMO CODE<\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_4_46' type='text' value='' class='large'    placeholder='Enter Promo Code to Get Discount'  aria-invalid=\"false\"   \/> <\/div><\/div><div class=\"spacer gfield\" style=\"grid-column: span 7;\"><\/div><div id=\"field_4_63\"  class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_hidden\"  data-js-reload=\"field_4_63\"><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><label class='gfield_label gform-field-label' for='input_4_63' >image url<\/label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_4_63' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_47\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_47\"><h4> <span id=\"PP\"><\/span> <span id=\"TP\"><\/span><\/h4><span id=\"FP\"><\/span><\/h4><\/div><div id=\"field_4_45\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_45\"><style>\n\/* ===== Premium Summary Table Styling ===== *\/\n.premium-summary {\n  border: 1px solid #ddd;\n  border-radius: 8px;\n  padding: 15px;\n  margin-top: 15px;\n  background: #f9f9f9;\n}\n\n.premium-summary h4 {\n  margin: 8px 0;\n  padding: 6px 10px;\n  font-size: 15px;\n  display: flex;\n  justify-content: space-between;\n  align-items: center;\n  border-bottom: 1px solid #eee;\n}\n\n.premium-summary h4:last-child {\n  border-bottom: none;\n}\n\n.premium-summary span#selectedPlan {\n  font-weight: 600;\n  color: #ba0c2f;\n}\n\n.premium-summary .highlight {\n  font-weight: 600;\n  color: #2e7d32;\n}\n<\/style>\n\n\n<script>\njQuery(document).on('gform_post_render', function () {\n\n  \/\/ --- Field mirroring logic ---\n  jQuery('#input_4_1').on('input', function () {\n    jQuery('#input_4_27').val(jQuery(this).val());\n  });\n  jQuery('#input_4_4').on('input', function () {\n    jQuery('#input_4_40').val(jQuery(this).val());\n  });\n  jQuery('#input_4_3').on('input', function () {\n    jQuery('#input_4_39').val(jQuery(this).val());\n  });\n  jQuery('#input_4_13').on('input', function () {\n    jQuery('#input_4_43').val(jQuery(this).val());\n  });\n\n\n  \/\/ --- Premium calculation and display ---\n  function updatePremiumDisplay(discountCode = '') {\n    let priceText = jQuery('#input_4_18').val() || '';\n    priceText = priceText.replace(\/PKR|,|\\s\/gi, '');\n    const price = parseFloat(priceText) || 0;\n\n    const selectedPlan = jQuery('#input_4_15').val() || '';\n    const isValidCode = discountCode.toUpperCase() === 'KHI2DSADE@0';\n\n    let discounted = 0;\n    let finalPremium = price;\n\n    if (isValidCode) {\n      discounted = price * 0.20;\n      finalPremium = price - discounted;\n    }\n\n    \/\/ Format numbers with commas and no decimals\n    const formatPKR = (num) => 'PKR ' + Math.round(num).toLocaleString();\n\n    \/\/ Build summary table\n    let html = '<div class=\"premium-summary\">';\n\n    if (isValidCode) {\n      html += '<h4><span>Total<\/span> <span>' + formatPKR(price) + '<\/span><\/h4>';\n      html += '<h4><span>Discount<\/span> <span>' + formatPKR(discounted) + '<\/span><\/h4>';\n    }\n\n    html +=\n      '<h4><span>Parents Care Plus <span id=\"selectedPlan\">' +\n      selectedPlan +\n      '<\/span><\/span> <span class=\"highlight\">' +\n      formatPKR(finalPremium) +\n      '<\/span><\/h4>';\n\n    html += '<\/div>';\n\n    jQuery('#PP').html(html);\n    jQuery('#input_4_61').val(formatPKR(finalPremium));\n  }\n\n  \/\/ Initialize on load\n  updatePremiumDisplay();\n\n  \/\/ Event listeners\n  jQuery('#input_4_18').on('input change', function () {\n    updatePremiumDisplay(jQuery('#input_4_46').val().trim());\n  });\n\n  jQuery('#input_4_46').on('input', function () {\n    updatePremiumDisplay(jQuery(this).val().trim());\n  });\n\n  jQuery('#input_4_15').on('change input', function () {\n    updatePremiumDisplay(jQuery('#input_4_46').val().trim());\n  });\n\n});\n<\/script>\n<\/div><div id=\"field_4_93\"  class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_93\"><div class='ginput_container ginput_container_text'><input name='input_93' id='input_4_93' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_4_57\"  class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_57\"><div class='ginput_container ginput_container_text'><input name='input_57' id='input_4_57' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_4_58\"  class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_58\"><div class='ginput_container ginput_container_text'><input name='input_58' id='input_4_58' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_4_64\"  class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_64\"><div class='ginput_container ginput_container_text'><input name='input_64' id='input_4_64' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_4_65\"  class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_65\"><div class='ginput_container ginput_container_text'><input name='input_65' id='input_4_65' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_4_59\"  class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_59\"><div class='ginput_container ginput_container_text'><input name='input_59' id='input_4_59' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_4_61\"  class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_61\"><div class='ginput_container ginput_container_text'><input name='input_61' id='input_4_61' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_4_60\"  class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_60\"><div class='ginput_container ginput_container_text'><input name='input_60' id='input_4_60' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_4_48\"  class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_48\"><div class='ginput_container ginput_container_text'><input name='input_48' id='input_4_48' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_4_96\"  class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_96\"><div class='ginput_container ginput_container_text'><input name='input_96' id='input_4_96' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_4_97\"  class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_97\"><div class='ginput_container ginput_container_text'><input name='input_97' id='input_4_97' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_4_99\"  class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_99\"><div class='ginput_container ginput_container_text'><input name='input_99' id='input_4_99' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_4_67\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_67\"><script>\njQuery(document).ready(function ($) {\n  console.log(\"Jubilee AJAX uploader initialized.\");\n\n  $('#input_4_52').on('change', function () {\n    var file = this.files[0];\n    if (!file) return;\n\n    \/\/ \u2705 Ensure required checkbox is checked before uploading\n    if (!$('#choice_4_51_1').is(':checked')) {\n      console.log(\"\u26a0\ufe0f Upload skipped \u2014 checkbox not selected.\");\n      $('.uploadStatus').text(\"\u26a0\ufe0f Please check the required option before uploading.\");\n      return;\n    }\n\n    $('.uploadStatus').text(\"\u23f3 Getting authorization token...\");\n\n    \/\/ Disable submit button during upload\n    $('#gform_submit_button_4')\n      .prop('disabled', true)\n      .css({ opacity: '0.6', cursor: 'not-allowed' });\n\n    \/\/ STEP 1 \u2192 Get Bearer Token\n    $.ajax({\n      url: \"\/ammi-abbu-kayliye-jubilee\/wp-admin\/admin-ajax.php\",\n      type: \"POST\",\n      data: { action: \"get_parent_care_token\" },\n      success: function (tokenResponse) {\n        if (tokenResponse.success && tokenResponse.data.token) {\n          const token = tokenResponse.data.token;\n          console.log(\"\u2705 Token retrieved:\", token);\n\n          \/\/ Save token in hidden field\n          $('#input_4_93').val(token).trigger('change');\n\n          \/\/ STEP 2 \u2192 Upload Image with token\n          uploadImage(file, token);\n        } else {\n          console.error(\"\u274c Failed to get token\", tokenResponse);\n          $('.uploadStatus').text(\"\u274c Failed to authenticate \u2014 please try again later.\");\n          $('#gform_submit_button_4').prop('disabled', false).css({ opacity: '1', cursor: 'pointer' });\n        }\n      },\n      error: function () {\n        $('.uploadStatus').text(\"\u26a0\ufe0f Authorization failed \u2014 please try again later.\");\n        $('#gform_submit_button_4').prop('disabled', false).css({ opacity: '1', cursor: 'pointer' });\n      },\n    });\n  });\n\n  \/\/ STEP 2 Function \u2192 Upload Image\n  function uploadImage(file, token) {\n    var formData = new FormData();\n    formData.append(\"action\", \"upload_parent_care_image\");\n    formData.append(\"image\", file);\n    formData.append(\"token\", token);\n\n    \/\/ \u2705 Determine site type based on #input_4_50 value\n    var siteValue = $('#input_4_50').val() === '45' ? 'takaful' : 'insurance';\n    formData.append(\"site\", siteValue);\n\n    console.log(\"Uploading image for site:\", siteValue);\n\n    $('.uploadStatus').text(\"\u23f3 Uploading image...\");\n\n    $.ajax({\n      url: \"\/ammi-abbu-kayliye-jubilee\/wp-admin\/admin-ajax.php\",\n      type: \"POST\",\n      data: formData,\n      processData: false,\n      contentType: false,\n      success: function (response) {\n        console.log(\"Response:\", response);\n\n        if (response.success && response.data) {\n          $('input[name=\"input_57\"]').val(response.data.image_name).trigger('change');\n          $('input[name=\"input_58\"]').val(response.data.file_path).trigger('change');\n          $('input[name=\"input_64\"]').val(response.data.success).trigger('change');\n          $('input[name=\"input_65\"]').val(response.data.message).trigger('change');\n\n          $('.uploadStatus').text(\"\u2705 Image Uploaded\");\n        } else {\n          console.error(\"Upload failed:\", response);\n          $('.uploadStatus').text(\n            \"\u274c Upload failed: \" +\n              (response.message ||\n                \"Please upload a different image \u2014 your image does not meet the required size or format.\")\n          );\n        }\n      },\n      error: function (xhr, status, error) {\n        console.error(\"AJAX error:\", error);\n        $('.uploadStatus').text(\"\u26a0\ufe0f Upload failed \u2014 check console for details.\");\n      },\n      complete: function () {\n        $('#gform_submit_button_4')\n          .prop('disabled', false)\n          .css({ opacity: '1', cursor: 'pointer' });\n      },\n    });\n  }\n});\n<\/script><\/div><div id=\"field_4_62\"  class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_hidden\"  data-js-reload=\"field_4_62\"><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><label class='gfield_label gform-field-label' for='input_4_62' >error<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_62' id='input_4_62' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_69\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_69\"><div class=\"Disclaim_Final\"><strong>Disclaimer:<\/strong><br>\n<a href=\"https:\/\/jubileegeneral.com.pk\/ammi-abbu-kayliye-jubilee\/wp-content\/uploads\/2025\/10\/parents_care_plus_terms.pdf\" target=\"_blank\">Please review the terms and conditions of policy before making your purchase.<\/a><\/div><\/div><div id=\"field_4_98\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_98\"><div class=\"Disclaim_Final\"><strong>Disclaimer:<\/strong><br>\n<a href=\"https:\/\/jubileegeneral.com.pk\/ammi-abbu-kayliye-jubilee\/wp-content\/uploads\/2025\/10\/Parents-Care-Policy-wordings_Takaful-.pdf\" target=\"_blank\">Please review the terms and conditions of membership before making your purchase.<\/a><\/div><\/div><fieldset id=\"field_4_70\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_4_70\"><legend class='gfield_label gform-field-label gfield_label_before_complex'  >I have clearly read, understood, and agree with the terms and conditions of Jubilee General Insurance Parents Care Plus Plan<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_4_70'><div class='gchoice gchoice_4_70_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_70.1' type='checkbox'  value='I have clearly read, understood, and agree with the terms and conditions of Jubilee General Insurance Parents Care Plus Plan, and I am aware of the waiting period of 30 days according to which this policy shall not cover any expenses during the first 30 days from the inception of the policy, except for accidental injuries. This waiting period shall not be applicable on the subsequent consecutive\u00a0renewals.'  id='choice_4_70_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_70_1' id='label_4_70_1' class='gform-field-label gform-field-label--type-inline'>I have clearly read, understood, and agree with the terms and conditions of Jubilee General Insurance Parents Care Plus Plan, and I am aware of the waiting period of 30 days according to which this policy shall not cover any expenses during the first 30 days from the inception of the policy, except for accidental injuries. This waiting period shall not be applicable on the subsequent consecutive\u00a0renewals.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_78\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_4_78\"><legend class='gfield_label gform-field-label gfield_label_before_complex'  >I have clearly read, understood, and agree with the terms and conditions of Jubilee General Takaful Parents Care Plus Plan<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_4_78'><div class='gchoice gchoice_4_78_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.1' type='checkbox'  value='I have clearly read, understood, and agree with the terms and conditions of Jubilee General Takaful Parents Care Plus Plan, and I am aware of the waiting period of 30 days according to which this membership shall not cover any expenses during the first 30 days from the inception of the membership, except for accidental injuries. This waiting period shall not be applicable on the subsequent consecutive\u00a0renewals.'  id='choice_4_78_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_78_1' id='label_4_78_1' class='gform-field-label gform-field-label--type-inline'>I have clearly read, understood, and agree with the terms and conditions of Jubilee General Takaful Parents Care Plus Plan, and I am aware of the waiting period of 30 days according to which this membership shall not cover any expenses during the first 30 days from the inception of the membership, except for accidental injuries. This waiting period shall not be applicable on the subsequent consecutive\u00a0renewals.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div><\/div>\n        <div class='gform_page_footer top_label'><input type='submit' id='gform_previous_button_4' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous'  onclick='if(window[\"gf_submitting_4\"]){return false;}  if( !jQuery(\"#gform_4\")[0].checkValidity || jQuery(\"#gform_4\")[0].checkValidity()){window[\"gf_submitting_4\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_4\"]){return false;} if( !jQuery(\"#gform_4\")[0].checkValidity || jQuery(\"#gform_4\")[0].checkValidity()){window[\"gf_submitting_4\"]=true;}  jQuery(\"#gform_4\").trigger(\"submit\",[true]); }' \/> <button type=\"submit\" id=\"gform_submit_button_4\" class=\"gform_button button gform-button--width-full\">Submit<\/button> \n            <input type='hidden' class='gform_hidden' 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data-id=\"f33d8be\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-c3f9eac e-con-full e-flex e-con e-child\" data-id=\"c3f9eac\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-cdd2aff elementor-widget elementor-widget-text-editor\" data-id=\"cdd2aff\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>\u00a9\u00a0<span id=\"year\">2026<\/span>\u00a0Jubilee General Insurance Company Limited. 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href=\"#popmake-1180\">Claims<\/a><\/li>\r\n        <\/ul>\r\n    <\/div>\r\n\r\n    <!-- More Details -->\r\n    <div class=\"footer-dropdown\">\r\n        <div class=\"parent-item\">More Details<\/div>\r\n        <ul class=\"sub-items\">\r\n            <li><a target=\"_blank\" href=\"\/coverage\/uploads\/pdfs\/sidenav\/Parents-Care-plus-Brochure.pdf\">Product Brochure<\/a><\/li>\r\n            <li><a target=\"_blank\" href=\"https:\/\/jubileegeneral.com.pk\/coverage\/uploads\/pdfs\/sidenav\/glossary-definitions.pdf\">Glossary<\/a><\/li>\r\n            <li><a target=\"_blank\" href=\"https:\/\/jubileegeneral.com.pk\/coverage\/uploads\/pdfs\/help_center\/faqs\/faqs-parent-care-plus-insurance.pdf\">FAQs<\/a><\/li>\r\n            <li><a target=\"_blank\" href=\"https:\/\/jubileegeneral.com.pk\/coverage\/uploads\/pdfs\/help_center\/policy_wording\/policy-wording-parents-care-plus-insurance.pdf\">Policy Wording<\/a><\/li>\r\n            <li><a target=\"_blank\" 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ease;\r\n}\r\n\r\n\/* Copy message *\/\r\n#copyMsg {\r\n  position: absolute;\r\n    top: -30px;\r\n    left: 20%;\r\n  font-size: 10px !important;\r\n  text-align: center;\r\n  background: rgb(0 0 0 \/ 27%);\r\n  color: #fff;\r\n  padding: 4px 8px;\r\n  border-radius: 4px;\r\n  display: none; \/* Hide by default *\/\r\n  z-index: 9999;\r\n}\r\n#copyMsg.show {\r\n  display: block; \/* Show when active *\/\r\n}\r\n<\/style>\r\n\r\n<script>\r\ndocument.addEventListener(\"DOMContentLoaded\", () => {\r\n  const copyBtn = document.querySelector(\".copyLink\");\r\n  const copyMsg = document.getElementById(\"copyMsg\");\r\n  const linkToCopy = \"https:\/\/jubileegeneral.com.pk\/ammi-abbu-kayliye-jubilee\/\";\r\n\r\n  copyBtn.addEventListener(\"click\", async () => {\r\n    try {\r\n      await navigator.clipboard.writeText(linkToCopy);\r\n      copyMsg.classList.add(\"show\");\r\n\r\n      \/\/ Hide message after 2 seconds\r\n      setTimeout(() => {\r\n        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