If hospitalization is furnished to a medically indigent person, the county is not liable for the cost of the hospitalization unless, within fifteen days in the case of an emergency admission, notice of the hospitalization is mailed to the auditor of the county. The notice shall contain:
(1) The name and last known address of the patient or the patient's guardian;
(2) The name and address of the responsible party, if known;
(3) The name of the attending physician;
(4) The nature and degree of severity of the illness;
(5) The anticipated diagnostic or therapeutic services required;
(6) The location at which the services are to be provided;
(7) The estimated reimbursement for the services; and
(8) A statement that the hospital has asked the patient or the responsible party, if known, whether the patient has served in any branch of the military, is potentially eligible for Indian Health Service benefits, or is a member of a Native American tribe and a statement of the information received in response to the inquiry.