58-23A-3. Form and contents of report on claims. Such reports shall be in writing on a form prescribed by the division and shall contain the following information:
(1) Name and address of physician, nurse, hospital, or other person or institution against which claim is made;
(2) Name, address, and age of the claimant or plaintiff;
(3) Nature and substance of the claim; and
(4) Date and place from which the claim arose.
Source: SL 1976, ch 316, § 2.