London Guarantee & Accident Co., Ltd. Claim Card

Front:
Form 3820 7-11-21 Claim No. 53212 192 4/24/23 J. McEv en Hos. of the P. E. Church Employe Employer Is employe able to work? Tont Sune thnt If so, from what date? c/5i1973 If not, when will he probably be able to wark?. Epierful Habithm JUN 13 1993 Employer

Back:
DELP JUN 12 laz-PM EPLY CA002 REN MARTHA INGTON London Guarantee & Accident Co., Ltd. 434 WALNUT STREET PHILADELPHIA, PA. Claim Dept.