Money Lent

(Title)

A.B., the above named plaintiff, states as follows:-

1. 1.On the day of 19, he lent the defendant rupees repayable on the day of
2. 2.The defendant has not paid the same, except rupees paid on the day of 19.

[If the plaintiff claims exemption from any law of limitation, say:-]

3. The plaintiff was a minor [or insane] from the day of till the day of
4. [Facts showing when the cause of action arose and that the Court has jurisdiction.]
5. The value of the subject-manner of the suit of the suit for the purpose of jurisdiction is rupees and for the purpose of court-fees is rupees.
6. The plaintiff claims rupees, with interest at percent from the day of 19.