Medical Insurance

<a name="quote"></a> <div style="max-width:400px; padding:10px; text-align:center;"> <div style="font-size:16px; color: #af0000; text-align:center"><strong>GET A QUOTE</strong></div> <div style="font-size:12px; color: #000; text-align:center">Day-to-Day Medical Plans from R360 per month</div> <div style="font-size:12px; color: #af0000; text-align:center">We will contact you with more information</div> <div style="padding: 5px; text-align:center;"><form action="https://www.quotecheck.co.za/webserv/mquote/TSquote.php" method="POST" name="form1" target="subm"> <input id="Firstname" name="Firstname" style="width:90%; padding:3px;" placeholder="First Name" /> <br/> <br/> <input id="Surname" name="Surname" style="width:90%; padding:3px;" placeholder="Surname" /> <br/> <br/> <input id="Email" name="Email" style="width:90%; padding:3px;"placeholder="Email Address" /> <br/> <br/> <input id="CellNo" maxlength="13" name="CellNo" style="width:90%; padding:3px;" placeholder="Cell Phone Number" /> <br/> <br/> <div id="submitDiv" style="display: none;text-align: center; background-color: #fff; color: #ff0000;"></div> <div id="resultDiv" style="display: none; background-color: #fff;"><iframe name="subm" height="80" scrolling="no"></iframe></div> <input id="SubButton" onclick="return validateForm();" style="width: 90%; font-size: 16px; font-weight: bold; background-color: #ff9710; padding: 10px;" type="submit" value="SUBMIT" /> </form> </div> </div> <script type="text/javascript" src="https://ajax.googleapis.com/ajax/libs/jquery/3.5.1/jquery.min.js"></script> <script src="https://www.quotecheck.co.za/webserv/mquote/validatenew.js"></script>