Claim ID: 16849
Submitted: Nov-21-2018
Requested Processing: Photos required
Name: Janesax
Email: legethetr7@probbox.com
Company: google
Phone: 81273886827
Their Claim No.:
Insured:
Policy No.:
Date of Loss: 1977-11-10
Insured Address: San Jose
Insured Telephone: 81932944428
Claimant Address: San Jose
Claimant Telephone: 82999238574
Loss Location
USA
Local Authorities:
Loss Description: amoxicillin 500mg
Handling Instructions: amoxicillin 500mg