Front:
Form 3820 7-11-21
Claim No. 53210
1923
David H. Brown 4/23/23
LT
Härry Sonenfeld
Employer
Employe
Is employe able to work?
10 128
If so, from what date?
able to work ?
tidie
propably be
when will h
hipowy
he
playmintiotra Hantasleo
tanithu Smo
banychatn
h5
so
May6called up
Employer
thinh
Abla me Hhedenf
comebach to me.
will
Back:
0930
KINGSEGSING STA
DEPLY
MARTHA WASHINGTON
London Guarantee & Accident Co., Ltd.
434 WALNUT STREET
Claim Dept.
PHILADELPHIA, PA.