POST https://testtips.vidalhealthtpa.com:7443/mobilerest/vidalbrokerservices/submitClaim
Authorization: Basic dmlkYWxicm9rZXJsb2dpbjp2aWRhbHN0YWdlQDEyMw==
Cookie: JSESSIONID=678ofNbsfB8svK1lyV6rON3w.worker1
Content-Type: multipart/form-data; boundary=WebApiBoundary

--WebApiBoundary
Content-Disposition: form-data; name="username"

Web_api
--WebApiBoundary
Content-Disposition: form-data; name="password"

Web@api
--WebApiBoundary
Content-Disposition: form-data; name="policyNo"

CI/TEST/POLICY/123456
--WebApiBoundary
Content-Disposition: form-data; name="enrollmentId"

BLR-RG-H0351-043-0000002-A
--WebApiBoundary
Content-Disposition: form-data; name="typeOfClaim"

Main hospitalization claim
--WebApiBoundary
Content-Disposition: form-data; name="claimSubType"

Hospitalization
--WebApiBoundary
Content-Disposition: form-data; name="requestedAmount"

4500
--WebApiBoundary
Content-Disposition: form-data; name="ailmentType"

Non covid
--WebApiBoundary
Content-Disposition: form-data; name="admissionDate"

20-03-2025
--WebApiBoundary
Content-Disposition: form-data; name="dischargeDate"

23-03-2025
--WebApiBoundary
Content-Disposition: form-data; name="hospitalName"

A G  HOSPITAL NEW
--WebApiBoundary
Content-Disposition: form-data; name="empanelmentNo"

HOS-PON-010427
--WebApiBoundary
Content-Disposition: form-data; name="documentType"

Claim
--WebApiBoundary
Content-Disposition: form-data; name="ailmentName"

Cold
--WebApiBoundary
Content-Disposition: form-data; name="hospitalAddress"

abc
--WebApiBoundary
Content-Disposition: form-data; name="hospitalState"

karnataka
--WebApiBoundary
Content-Disposition: form-data; name="hospitalCity"

bangalore
--WebApiBoundary
Content-Disposition: form-data; name="hospitalPinCode"

560036
--WebApiBoundary
Content-Disposition: form-data; name="hospitalPhoneNo"

7656879899
--WebApiBoundary
Content-Disposition: form-data; name="File"; filename="tracker.pdf"
Content-Type: application/pdf

< ./C:\Users\jvadi\Downloads\Tickets - Business Show_ Chennai (India) (06_11_2025 14_00_00) - vadivel.pdf
--WebApiBoundary--


// claim