PASI Intimation Form
"When you are intimated of death or injury of an Omani employee, please do not hesitate to inform us in order to introduce the service to him and his family" 
* indicates mandatory fields.
Incident Type Work Injury  Death
Employee Name *
Company Name *
Insurance No. or ID No. ( If exists ) Insurance No. :

ID No. :              

Incident Date

Please write your name and your telephone in case any additional information is required

Name :                

Telephone No. :