Form 49.13-B

Form of certificate by medical officer or hospital or similar institution

IN THE COURT OF SESSION

**(Cause reference number)

in the cause

**[A.B.] (designation and address)
						Pursuer

against

**[C.D.] (designation and address)

						Defender

I, (name of medical officer), hereby certify as follows:-

1.  I have received a copy summons in the action of (pursuer’s name) against (defender’s name).  The defender is under my care at (address).  

*2.  On (date) I personally delivered the copy summons to the defender and explained to him [or her] its contents.  

*2  I have not delivered the copy summons to the defender nor have I explained its contents.  My reasons are:-

				Signature ……………………………………
				Name ………………………………………..
				Address  …………………………………….
				              ……………………………………..
				              ……………………………………..
					  ……………………………………..
				Date …………………………………………

** To be completed by or on behalf of the pursuer.  
* Medical officer to delete as appropriate.