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Get Md Request For Medical Excuse From Jury Service - Baltimore City 2018

COPIES are not accepted. FAXES will ONLY be accepted if received from the signing physician s office. Please be certain that information is written legibly and as much as possible, use plain language to describe the medical condition. PATIENT S NAME JUROR ID#: JUROR S PHONE NUMBER: DATE OF JURY SUMMONS: JUROR S AGE: CURRENT OCCUPATION:.

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