_________ (Mention hospital’s details)

Date: __/__/_____ (Date)

Subject: Apology for delay in submission of documents

Sir/ Madam,

My name is _________ (name) and I would like to inform on __/__/____ (date), my __________ (relative details) got admitted in your hospital for treatment of ___________ (mention treatment name). And, he/she is supposed to get discharged today but unfortunately due to the reason _______ (mention reason) I was not able to submit ___________ (name of the document). I assure that will be submitting the document by __/__/____ (date).

It is to request you to kindly help me by providing me an extension in the submission date of ___________ (document name).

The following are the details of the patient:

Patient name: _________ (Patient name),
Patient ID: ________ (Patient ID)
Patient room number: __________ (Room number)

Looking forward to your kind support.

Yours Truly,
__________ (signature),
__________ (name),
__________ (contact number)

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