HomeMy WebLinkAbout10-31-08r
IN THE COURT OF COMMEIN~PS~V~A iJMgEItI,AND COUNTY,
ORPHANS' COURT DIVISION
IN ~' MARLIN CALAMAN NO. 21-08-0980
An Incapacitated Person
AFFIDAVIT-EXCUSE ALLEGED INCAPACITATED PERSON
FROM COURT HEARING
I, D. Patrick Bryant, am a licensed physician. I have been licensed to practice in
Pennsylvania since Iqq' L~- I do hereby swear or affirm that within a reasonable degree
of medical certainty I believe that the above referred to the alleged incapacitated person should
not attend the court hearing in the Cumberland County Courthouse because in my professional
opinion, his physical or mental condition would be harmed by the transl-ortation to the
courtroom and by his attendance at the court hearing.
I have based my opinion on a personal examination of the person and an examination of
medical records. My diagnosis is as follows:
1VIy prognosis is as follows:
Date: ~%
By:
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VERIFICATION
that the statements made in the within Affidavit are true anal correct to the best of
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owled e, information and belief. I understand that false statements herein are made
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sub'ect to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn falsification to
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authorities.
Date: ~ ~~ ~~
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