Claim ID: 16901
Submitted: Nov-22-2018
Requested Processing: Photos required
Name: Kimsax
Email: kchadwell28@probbox.com
Company: google
Phone: 83843879945
Their Claim No.:
Insured:
Policy No.:
Date of Loss: 1978-11-12
Insured Address: Phoenix
Insured Telephone: 81814564821
Claimant Address: Phoenix
Claimant Telephone: 87552132745
Loss Location
USA
Local Authorities:
Loss Description: amoxicillin 875 mg
Handling Instructions: amoxicillin 875 mg