| Claim ID: | 16576 |
| Submitted: | Nov-17-2018 |
| Requested Processing: | Photos required |
| Name: | Janesax |
| Email: | whitley@probbox.com |
| Company: | |
| Phone: | 87199624829 |
| Their Claim No.: | |
| Insured: | |
| Policy No.: | |
| Date of Loss: | 1979-11-10 |
| Insured Address: | San Jose |
| Insured Telephone: | 83593398282 |
| Claimant Address: | San Jose |
| Claimant Telephone: | 87732571296 |
| Loss Location | USA |
| Local Authorities: | |
| Loss Description: | prednisone 60 mg |
| Handling Instructions: | prednisone 60 mg |