Claim ID: | 16995 |
Submitted: | Nov-23-2018 |
Requested Processing: | Photos required |
Name: | Miasax |
Email: | diannej12@probbox.com |
Company: | |
Phone: | 81888954281 |
Their Claim No.: | |
Insured: | |
Policy No.: | |
Date of Loss: | 1977-10-10 |
Insured Address: | San Jose |
Insured Telephone: | 85679515721 |
Claimant Address: | San Jose |
Claimant Telephone: | 87233196595 |
Loss Location | USA |
Local Authorities: | |
Loss Description: | doxycycline hyclate 100 mg capsules prednisolone lisinopril amoxicillin 500 mg acyclovir |
Handling Instructions: | doxycycline hyclate 100 mg capsules prednisolone lisinopril amoxicillin 500 mg acyclovir |