COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.PROBATE COURT OF HAMILTON COUNTY, OHIOCalendar No.JAMES CISSELL, JUDGEJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)PLACEMENT OF(Name before placement) CASE NO.HOSPITAL RELEASE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .TO:Name of HospitalPEOPLE OF THE STATE OF NEW YORKThe Court has issued an order approving the placement for adoption of a certain (male)(female) infant born on theday of, with,andGREETINGS:husband and wife, who have filed a Petition for Adoption with this Court.WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the HonorableTheHospital may release said child to,located at County ofand, oro'clock in the day ofnoon, and at any recessed room, on the, 20, at adjourned date, to testify and give evidence as a witness in this action on the part of thetheir attorney,, upon presentation of a certified copy of thisHospital Release.Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply., one of the Justices of theIt is further ordered that the Hospital keep the information contained in this Hospital Release strictly confidential. Said information contained herein is sealed under Ohio law. Inquiries into the release of this information should be directed to the Hamilton County Probate Court.Court in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)James Cissell, Probate JudgeAttorney(s) forOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com02/10/03H.C. FORM 118.32 -HOSPITAL RELEASE
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