Claim ID: 16476
Submitted: Nov-16-2018
Requested Processing: Photos required
Name: Evasax
Email: cherry@probbox.com
Company: google
Phone: 84957665422
Their Claim No.:
Insured:
Policy No.:
Date of Loss: 1978-12-11
Insured Address: New York
Insured Telephone: 87121875121
Claimant Address: New York
Claimant Telephone: 82899878188
Loss Location
USA
Local Authorities:
Loss Description: ventolin hfa 90 mcg
Handling Instructions: ventolin hfa 90 mcg