SDCL § 58-23A-3: Form and contents of report on claims.

Such reports shall be in writing on a form prescribed by the division and shall contain the following information:

(1) Name and address of physician, nurse, hospital, or other person or institution against which claim is made;

(2) Name, address, and age of the claimant or plaintiff;

(3) Nature and substance of the claim; and

(4) Date and place from which the claim arose.