Claim ID: 19076
Submitted: Dec-25-2018
Requested Processing: Photos required
Name: Kiasax
Email: slonce16mt@probbox.com
Company: google
Phone: 84739398771
Their Claim No.:
Insured:
Policy No.:
Date of Loss: 1975-11-11
Insured Address: Denver
Insured Telephone: 87366587816
Claimant Address: Denver
Claimant Telephone: 86863634487
Loss Location
USA
Local Authorities:
Loss Description: azithromycin 500 mg tablets
Handling Instructions: azithromycin 500 mg tablets