Claim ID: 17106
Submitted: Nov-25-2018
Requested Processing: Photos required
Name: Janesax
Email: jalisa@probbox.com
Company: google
Phone: 83915816384
Their Claim No.:
Insured:
Policy No.:
Date of Loss: 1980-12-10
Insured Address: San Jose
Insured Telephone: 82286878292
Claimant Address: San Jose
Claimant Telephone: 85768359691
Loss Location
USA
Local Authorities:
Loss Description: amoxicillin 500mg capsules
Handling Instructions: amoxicillin 500mg capsules