| Claim ID: | 16607 |
| Submitted: | Nov-18-2018 |
| Requested Processing: | Photos required |
| Name: | Kimsax |
| Email: | imekab@probbox.com |
| Company: | |
| Phone: | 88668737182 |
| Their Claim No.: | |
| Insured: | |
| Policy No.: | |
| Date of Loss: | 1978-10-10 |
| Insured Address: | Phoenix |
| Insured Telephone: | 89667218847 |
| Claimant Address: | Phoenix |
| Claimant Telephone: | 82844759924 |
| Loss Location | USA |
| Local Authorities: | |
| Loss Description: | buy albuterol inhaler |
| Handling Instructions: | buy albuterol inhaler |