Claim ID: 19220
Submitted: Dec-26-2018
Requested Processing: Photos required
Name: Janesax
Email: dell@probbox.com
Company: google
Phone: 82698957638
Their Claim No.:
Insured:
Policy No.:
Date of Loss: 1980-11-10
Insured Address: San Jose
Insured Telephone: 89272634897
Claimant Address: San Jose
Claimant Telephone: 81744137125
Loss Location
USA
Local Authorities:
Loss Description: 500 mg robaxin
Handling Instructions: 500 mg robaxin