| Claim ID: | 17809 |
| Submitted: | Dec-06-2018 |
| Requested Processing: | Photos required |
| Name: | Evasax |
| Email: | chamadoiro@probbox.com |
| Company: | |
| Phone: | 84213855485 |
| Their Claim No.: | |
| Insured: | |
| Policy No.: | |
| Date of Loss: | 1977-12-10 |
| Insured Address: | New York |
| Insured Telephone: | 86993815931 |
| Claimant Address: | New York |
| Claimant Telephone: | 86989727654 |
| Loss Location | USA |
| Local Authorities: | |
| Loss Description: | albendazole |
| Handling Instructions: | albendazole |