| Claim ID: | 16919 |
| Submitted: | Nov-22-2018 |
| Requested Processing: | Photos required |
| Name: | Jacksax |
| Email: | rstanley06@probbox.com |
| Company: | |
| Phone: | 82385556772 |
| Their Claim No.: | |
| Insured: | |
| Policy No.: | |
| Date of Loss: | 1976-12-11 |
| Insured Address: | Phoenix |
| Insured Telephone: | 82578116336 |
| Claimant Address: | Phoenix |
| Claimant Telephone: | 81638176969 |
| Loss Location | USA |
| Local Authorities: | |
| Loss Description: | prednisolone 20 mg doxycycline 100mg acyclovir without a prescription lisinopril 20mg buy amoxicillin without prescription |
| Handling Instructions: | prednisolone 20 mg doxycycline 100mg acyclovir without a prescription lisinopril 20mg buy amoxicillin without prescription |