44:5-19.2.Ā  Form The lien shall state the name of the patient, the date of his admission, theĀ  rate at which payment is made by the county for such patient's medical care andĀ  hospitalization, the name of the institution in which such service was renderedĀ  and the amount due to the county for such service at the date of the filing ofĀ  the lien and the rate of accumulation, if any shall occur, thereafter and shallĀ  be signed by the director of the board of chosen freeholders of the county orĀ  such person as shall be authorized so to do by resolution of said board.

L.1957, c. 139, p. 530, s. 2.
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