_____ District, _____
Sub : Request for issuing the _____ Certificate in the name of the injured _____
1- That my client namely _____ son of _____resident of _____ met with an accident on _____ near _____ and he sustained injuries over his body. He remained under the treatment of _____ and the _____ No. _____ was prepared.
2- That my client has filed the claim petition under section _____ of the _____ in the court of _____, _____ and the same is pending and fixed for _____.
3- That my client requires the _____ certificate for proving his _____.
You are therefore, requested that the _____ certificate of the injured _____ may kindly be issued to him as per the rules and regulations.
_____ Advocate, _____