Form - Submit - Display

Hi

I am working in a project where I have a form that is designed similar to the attachment(i.e center aligned). When the user submits the data we show them the data to verify and then submit. For that view I have designed it consistent with the form (assume the forms are filled in the attachment).

My question is when the same information is displayed in other screens with some more demographics information how shall we display that? If anyone can send a visual it would be great.

i hope this makes sense....

thanks

scenario: An applicatiion for insurance company where staff of the company will enter the producer information and wants to view it at a later stage.