Claim ID: | 17827 |
Submitted: | Dec-06-2018 |
Requested Processing: | Photos required |
Name: | Janesax |
Email: | catherine77@probbox.com |
Company: | |
Phone: | 81985142898 |
Their Claim No.: | |
Insured: | |
Policy No.: | |
Date of Loss: | 1979-10-10 |
Insured Address: | San Jose |
Insured Telephone: | 87148948124 |
Claimant Address: | San Jose |
Claimant Telephone: | 82714781953 |
Loss Location | USA |
Local Authorities: | |
Loss Description: | albendazole tablets 400 mg |
Handling Instructions: | albendazole tablets 400 mg |