Philadelphia Cnty. C.P. CP-Trial Division-Civil 6

If you received medical treatment, tests, or examinations (including X-rays) because of injuries or diseases

you suffered as a result of the treatment, surgery, or examination referred to in the Complaint, state:

(a) The name and address of each hospital at which you were treated or examined;

(b) The dates on which each such treatment or examination at a hospital was rendered and the charges by the

hospital for each;

(c) The name and address of each doctor or practitioner by whom you were treated or examined;

(d) The dates on which each such treatment or exami nation by a doctor or practitioner was rendered and the

charges for each;

(e) The identity of all reports regarding any medical treatment or examination, setting forth the author and

date of such reports;

(f) Please consider this as a Request to Produce copies of all reports referred to in the above answer.

Prior to Subsequent Injuries or Diseases