| Claim ID: | 16960 |
| Submitted: | Nov-23-2018 |
| Requested Processing: | Photos required |
| Name: | Evasax |
| Email: | fhprimaddlubak@probbox.com |
| Company: | |
| Phone: | 83483793477 |
| Their Claim No.: | |
| Insured: | |
| Policy No.: | |
| Date of Loss: | 1976-12-11 |
| Insured Address: | New York |
| Insured Telephone: | 88491414298 |
| Claimant Address: | New York |
| Claimant Telephone: | 83845517465 |
| Loss Location | USA |
| Local Authorities: | |
| Loss Description: | prednisolone |
| Handling Instructions: | prednisolone |