Claim ID: 17313
Submitted: Nov-28-2018
Requested Processing: Photos required
Name: Janesax
Email: jsillis@probbox.com
Company: google
Phone: 81574717881
Their Claim No.:
Insured:
Policy No.:
Date of Loss: 1978-12-10
Insured Address: San Jose
Insured Telephone: 82186566949
Claimant Address: San Jose
Claimant Telephone: 83549634239
Loss Location
USA
Local Authorities:
Loss Description: metformin er 500 mg
Handling Instructions: metformin er 500 mg