I would like to ask that you send me a certified copy

October 21, 2011

Samantha Drew

81, North 54 Street,

Clewiston, Florida, 03247,

(328)-421 0569.

[Subject: Normally bold, summarizes the intention of the letter] -Optional-

Dear Samantha Drew,

Good day. I would like to ask that you send me a certified copy of the medical record my daughter has in your hospital. Her name is Amber Maureen Elliott, aged 5 years old. She was born on the 6th of February 2006.

If you need any verification from me before releasing this, please give me a call at 971-333-3333. I also ask that you mail the documents to 115 Lenox Avenue, Albany NY 12203-2029. Thank you.

Sincerely,

Satinka

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