To,

The CMO/PMO
_____ District, _____

Sub :    Request for issuing the _____ Certificate in the name of the injured _____

Sir,

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.

Thanking you,

_____ Advocate, _____