death, I bow before You, unworthy and miserable sinner that I am, to implore You to cure ...(name the person on behalf of whom You are asking this blessing) who is so dear to my heart.
He (she) is in great suffering, wracked
with pain, and can find no relief except in You, in whom he (she) puts his (her) hope. Relieve him (her) in his (her) agony, o heavenly Doctor, free him (her) from his (her) suffering and give him (her) perfect health, if that be Your divine will and for the good of his (her) soul. Amen