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Text File  |  1978-06-02  |  4KB  |  61 lines
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  26. Datum                                                                 
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  31. Unfallversicherung                                                    
  32. Versicherungsscheinnummer : .........                                 
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  36. Sehr geehrte Damen und Herren,                                        
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  38. am 00.00.91  wurde mein Mann .......... bei seinem abendlichen        
  39. Spaziergang von einem PKW mit dem amtlichen Kennzeichen ......        
  40. angefahren.                                                           
  41. Mein Mann wird zur Zeit im städtischen Krankenhaus ...........        
  42. behandelt.                                                            
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  44. Vorgang :       (Hier bitte den genauen Hergang schildern )           
  45. Zeugen :      ................................................        
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  47. Ich möchte Sie bitten alles Erforderliche für uns in die Wege         
  48. zu leiten.                                                            
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  50. Mit freundlichem Gruß                                                 
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