Extracted text (via tesseract_tsv)
103056 characters
Maricopa County
Animal Care and Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.
(602) 506-2739 Fax
| t- &0°° (5
KENNEL PERMIT
APPLICATION
4 New L] Renewal
aZ
yisting 1A
savacligrare Hei péle ro -Cerretero |
# Kennel Name: Ferez
Mailing Address: 9009 S Calle Sahuaro Kennel Address: Same
City: Guadalupe State: AZ Zip: 85283 City: Guadalupe Zip: 85283
County Supervisorial District: 1
Phone: 480-283-5048
Please complete and sign this application and return it to the above address with payment in the amount of three
hundred twenty-eight dollars ($328.00) within ten (10) days of receipt.
NOTE: Failure to renew the kennel permit by the expiration date of the previous year kennel permit will result in
penalty fees for each dog being assessed at $4 per month for unaltered dog and $2 per month for altered dog in
addition to the permit fee. It is suggested the renewal application be submitted 4 — 6 weeks in advance of the
expiration date to allow timely processing.
Pursuant to Arizona statute and county ordinance, a person must obtain a kennel permit issued by the Board
of Supervisors if the person operates a kennel in which there are five or more dogs which are not individually
licensed. A.R.S. §11-1009(A). A kennel is defined as “an enclosed, controlled area, inaccessible to other
animals, in which a person keeps, harbors or maintains five or more dogs under controlled conditions.” A.R.S.
§ 11-1001(8).
An appointment will be scheduled for inspection of the kennel premises by an Animal Control Officer upon
receipt of this kennel permit application and fee. This kennel application properly executed and a copy of the
inspection report will then be forwarded to, and _must_be approved by, the Maricopa County Board of
Supervisors. The kennel permit form will be sent to you after approval and will be valid for one year from the
date of the Board’s approval.
NOTE: Failure to show for a scheduled inspection and/or failure of inspection will warrant a Subsequent
Inspection Return fee of $49 for each additional visit at time of inspection. Failure of inspection may result in
denial of the kennel permit and require individual licensing of each dog under the provisions of A.R.S. §11-
1008.
PLEASE ANSWER THE FOLLOWING QUESTIONS AND INITIAL EACH RESPONSE
wy
y We assume complete responsibility for the kennel at the premises for which I/we are making
application for a permit and understand that “kennel” means an enclosed, controlled area, inaccessible to
other animals, in which a person keeps, harbors or maintains five or more dogs under controlled
conditions (ARS 11-1001).
Lie certify that I/We have ___ | ‘ _ dogs and that the kennel meets the definition in statute.
IMWe certify that I/We have not been convicted of a violation of A.R.S. §§ 13-2910 (cruelty to animals)
AS 3-2910.01 (dog fighting), or similar violations of any other state, county or municipal animal welfare law.
. (Violations of license and leash laws DO NOT apply).
Zi) CANWe certify that all dogs over the age of three (3) months that are kept, harbored or maintained on the
prernises of the above named kennel have been properly vaccinated against rabies by a veterinarian licensed to
practice in the state of Arizona and that a current vaccination certificate signed by a licensed veterinarian is
maintained on the premises for each dog.
at Zi IWe certify that We are submitting a valid copy of the rabies vaccination certificate for each
dog with this application.
y
6. (ce understand that a dog remaining within the kennel is not required to be licensed individually under
A.R‘S. § 11-1008. I/we also understand that a dog leaving the controlled kennel conditions shall be licensed
under A.R.S. § 11-1008 except if the dog is only being transported to another kennel which has a permit issued
under section.
pre
aT We understand that a person who fails to obtain a kennel permit under A.R.S.§11-1009 is subject to a
ry
of twenty-five dollars in addition to the annual fee.
of
BY, (We understand that a person who knowingly fails to obtain a kennel permit within thirty days after
written notification from the county enforcement agent is guilty of a class 2 misdemeanor..
/ '
a,
9.4 = The undersigned understand that that the kennel permit does not authorize the operation of any type
of business and is solely used for the purpose of licensing multiple dogs.
I/We certify that all of the information I/We have provided is true and accurate under penalty of law.
.
* |) ¢ 2 f .
/ :
Applicant Signet Doe (Zio pay) / Date: ! L | Lo
Applicant Signature fz Ang Wie Gvefe$ Date 3.9 f Le
For Official Use Only:
Copies of Valid Rabies Vaccination Certificates for each dog attached
Copy of Person’s Valid Identification Attached
Type of Identification submitted
BOS Approval Date Term of Permit
October 2015
Maricopa County
Animal Care & Control
2500 South 27" Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.maricopa.gov
KENNEL PERMIT KT$-000063
PREMISE INSPECTION
Number of Dogs: 19
5 1 8 1 1 2 1960 968 8 13 14.080982 4
5 1 8 1 1 3 2088 960 159 28 79.246002 KENNE
4 1 8 1 2 0 221 925 2054 102 -1
5 1 8 1 2 1 221 987 145 36 93.305519 Name:
5 1 8 1 2 2 388 987 221 36 91.851036 Ernestina
5 1 8 1 2 3 630 987 127 36 96.405815 Perez
5 1 8 1 2 4 1167 984 160 37 95.971985 Kennel
5 1 8 1 2 5 1348 984 145 36 96.830040 Name:
5 1 8 1 2 6 1514 967 183 57 85.170090 Perez
5 1 8 1 2 7 1728 989 19 6 66.849518 -
5 1 8 1 2 8 1801 934 213 93 57.334934 arretert
5 1 8 1 2 9 2054 929 46 98 83.078568 Ke
5 1 8 1 2 10 2262 925 13 69 64.584702 |
2 1 9 0 0 0 218 1101 1603 287 -1
3 1 9 1 0 0 218 1101 1603 287 -1
4 1 9 1 1 0 220 1101 1487 51 -1
5 1 9 1 1 1 220 1105 166 47 96.612480 Mailing
5 1 9 1 1 2 403 1105 211 37 96.606506 Address:
5 1 9 1 1 3 634 1104 106 37 93.294762 9009
5 1 9 1 1 4 759 1104 29 36 93.285034 S
5 1 9 1 1 5 807 1104 115 36 92.548393 Calle
5 1 9 1 1 6 940 1103 196 37 91.181717 Sahuaro
5 1 9 1 1 7 1169 1102 160 37 95.976463 Kennel
5 1 9 1 1 8 1347 1102 210 37 95.734138 Address:
5 1 9 1 1 9 1577 1101 130 37 95.734138 Same
4 1 9 1 2 0 219 1219 1602 51 -1
5 1 9 1 2 1 219 1223 102 47 95.714516 City:
5 1 9 1 2 2 342 1222 255 47 96.006805 Guadalupe
5 1 9 1 2 3 615 1222 130 37 96.173492 State:
5 1 9 1 2 4 764 1222 64 37 96.504883 AZ
5 1 9 1 2 5 858 1221 86 47 95.492569 Zip:
5 1 9 1 2 6 966 1221 135 37 93.098824 85283
5 1 9 1 2 7 1157 1221 103 47 93.085556 City:
5 1 9 1 2 8 1295 1219 253 47 91.536911 Guadalupa
5 1 9 1 2 9 1578 1219 87 47 96.139977 Zip:
5 1 9 1 2 10 1686 1219 135 37 96.903557 85283
4 1 9 1 3 0 218 1325 798 63 -1
5 1 9 1 3 1 218 1341 168 47 92.616959 County
5 1 9 1 3 2 402 1340 309 48 91.503860 Supervisorial
5 1 9 1 3 3 732 1339 182 38 96.272034 District:
5 1 9 1 3 4 933 1339 53 38 95.558380 #6
5 1 9 1 3 5 1005 1325 11 61 84.626381 |
2 1 10 0 0 0 219 1455 1611 41 -1
3 1 10 1 0 0 219 1455 1611 41 -1
4 1 10 1 1 0 219 1455 1611 41 -1
5 1 10 1 1 1 219 1459 162 37 96.227814 Phone:
5 1 10 1 1 2 400 1458 308 38 96.000778 480-283-5048
5 1 10 1 1 3 1161 1456 159 37 96.761093 Kennel
5 1 10 1 1 4 1341 1456 161 37 96.289360 Phone:
5 1 10 1 1 5 1522 1455 308 38 96.289360 480-283-5048
2 1 11 0 0 0 295 1638 1803 169 -1
3 1 11 1 0 0 295 1638 1803 169 -1
4 1 11 1 1 0 295 1638 1803 51 -1
5 1 11 1 1 1 295 1644 32 36 95.998878 1.
5 1 11 1 1 2 365 1644 76 36 96.697922 Are
5 1 11 1 1 3 459 1642 45 38 96.697922 all
5 1 11 1 1 4 522 1642 104 47 96.698448 dogs
5 1 11 1 1 5 645 1651 93 28 96.817802 over
5 1 11 1 1 6 752 1642 69 37 96.446548 the
5 1 11 1 1 7 838 1651 80 37 96.758636 age
5 1 11 1 1 8 936 1641 42 37 96.746078 of
5 1 11 1 1 9 990 1641 113 37 96.137558 three
5 1 11 1 1 10 1121 1641 159 37 96.115837 months
5 1 11 1 1 11 1299 1639 177 48 96.675804 properly
5 1 11 1 1 12 1491 1639 234 38 96.815704 vaccinated
5 1 11 1 1 13 1743 1639 59 37 96.917572 for
5 1 11 1 1 14 1819 1638 130 38 96.918694 rabies
5 1 11 1 1 15 1968 1638 77 37 96.928520 and
5 1 11 1 1 16 2066 1638 32 37 96.327675 in
4 1 11 1 2 0 368 1697 1128 110 -1
5 1 11 1 2 1 368 1700 244 107 33.602634 eal
5 1 11 1 2 2 631 1699 41 38 96.478516 of
5 1 11 1 2 3 687 1710 23 26 96.478516 a
5 1 11 1 2 4 727 1699 98 37 96.131683 valid
5 1 11 1 2 5 846 1699 131 37 96.131683 rabies
5 1 11 1 2 6 994 1698 245 38 96.889793 vaccination
5 1 11 1 2 7 1258 1697 238 37 96.308510 certificate?
2 1 12 0 0 0 291 1868 1917 169 -1
3 1 12 1 0 0 291 1868 1917 169 -1
4 1 12 1 1 0 291 1868 1917 47 -1
5 1 12 1 1 1 291 1874 36 36 96.886543 2.
5 1 12 1 1 2 370 1873 32 37 89.363243 Is
5 1 12 1 1 3 418 1873 67 37 93.799576 the
5 1 12 1 1 4 504 1872 141 38 96.418198 kennel
5 1 12 1 1 5 664 1882 50 27 95.294258 an
5 1 12 1 1 6 733 1872 208 43 95.294258 enclosed,
5 1 12 1 1 7 962 1871 211 37 96.541702 controlled
5 1 12 1 1 8 1193 1881 106 33 96.692368 area,
5 1 12 1 1 9 1322 1869 266 38 96.033325 inaccessible
5 1 12 1 1 10 1604 1871 39 36 96.033325 to
5 1 12 1 1 11 1662 1869 113 37 96.204102 other
5 1 12 1 1 12 1791 1869 179 44 95.923965 animals,
5 1 12 1 1 13 1992 1869 32 36 95.923965 in
5 1 12 1 1 14 2041 1868 125 37 95.975403 which
5 1 12 1 1 15 2186 1878 22 27 96.745293 a
4 1 12 1 2 0 368 1926 1818 111 -1
5 1 12 1 2 1 368 1941 146 96 49.373035 a
5 1 12 1 2 2 534 1930 140 47 96.601105 keeps,
5 1 12 1 2 3 696 1929 164 38 96.673126 harbors
5 1 12 1 2 4 878 1939 42 27 96.646477 or
5 1 12 1 2 5 937 1929 209 37 96.462090 maintains
5 1 12 1 2 6 1162 1928 76 37 96.695923 five
5 1 12 1 2 7 1256 1938 42 27 96.883667 or
5 1 12 1 2 8 1315 1938 109 27 96.825996 more
5 1 12 1 2 9 1441 1927 105 47 96.763184 dogs
5 1 12 1 2 10 1565 1927 124 37 96.732285 under
5 1 12 1 2 11 1706 1926 211 38 96.616760 controlled
5 1 12 1 2 12 1937 1926 249 37 96.030464 conditions?
2 1 13 0 0 0 218 2160 2023 110 -1
3 1 13 1 0 0 218 2160 2023 110 -1
4 1 13 1 1 0 218 2160 2023 53 -1
5 1 13 1 1 1 218 2166 148 38 96.397079 NOTE:
5 1 13 1 1 2 401 2165 150 48 96.340591 Copies
5 1 13 1 1 3 570 2164 41 38 96.432373 of
5 1 13 1 1 4 626 2164 102 38 96.338570 each
5 1 13 1 1 5 748 2164 131 37 96.477699 rabies
5 1 13 1 1 6 896 2163 247 38 96.354988 vaccination
5 1 13 1 1 7 1161 2163 210 37 96.516212 certificate
5 1 13 1 1 8 1390 2163 105 36 96.304268 must
5 1 13 1 1 9 1513 2161 50 38 96.304268 be
5 1 13 1 1 10 1581 2161 187 38 96.128128 attached
5 1 13 1 1 11 1786 2163 40 35 96.557648 to
5 1 13 1 1 12 1842 2161 68 37 96.905914 the
5 1 13 1 1 13 1929 2160 149 38 95.809021 Kennel
5 1 13 1 1 14 2098 2160 143 38 96.481064 Permit
4 1 13 1 2 0 219 2222 543 48 -1
5 1 13 1 2 1 219 2224 177 37 96.273956 Premise
5 1 13 1 2 2 417 2223 219 47 95.757118 Inspection
5 1 13 1 2 3 654 2222 108 37 95.757118 form.
2 1 14 0 0 0 217 2394 1903 170 -1
3 1 14 1 0 0 217 2383 1903 181 -1
4 1 14 1 1 0 217 2394 1903 43 -1
5 1 14 1 1 1 217 2398 322 39 96.530899 CORRECTIVE
5 1 14 1 1 2 556 2398 184 37 96.718391 ACTION
5 1 14 1 1 3 761 2397 203 38 95.607918 NEEDED
5 1 14 1 1 4 983 2397 101 37 96.191246 FOR
5 1 14 1 1 5 1101 2396 328 37 96.196693 COMPLIANCE
5 1 14 1 1 6 1446 2395 104 37 96.583145 AND
5 1 14 1 1 7 1821 2394 131 38 96.327942 DAYS
5 1 14 1 1 8 1970 2394 150 37 96.982033 GIVEN
4 1 14 1 2 0 218 2453 1821 51 -1
5 1 14 1 2 1 218 2458 202 38 93.053650 BEFORE
5 1 14 1 2 2 440 2457 380 38 92.005669 REINSPECTION.
5 1 14 1 2 3 854 2457 129 47 96.469246 (Note:
5 1 14 1 2 4 1016 2456 129 37 96.356232 There
5 1 14 1 2 5 1160 2455 66 38 96.356232 will
5 1 14 1 2 6 1245 2455 51 37 96.188080 be
5 1 14 1 2 7 1314 2453 79 45 92.362694 $49
5 1 14 1 2 8 1413 2454 214 47 91.435921 re-inspect
5 1 14 1 2 9 1642 2454 69 37 96.210045 fee
5 1 14 1 2 10 1729 2454 171 47 96.497261 payable
5 1 14 1 2 11 1916 2455 40 35 96.691002 to
5 1 14 1 2 12 1972 2453 67 37 96.635979 the
4 1 14 1 3 0 219 2514 930 50 -1
5 1 14 1 3 1 219 2517 201 47 96.359978 Inspector
5 1 14 1 3 2 437 2516 49 47 96.688805 by
5 1 14 1 3 3 502 2515 128 37 96.910858 check
5 1 14 1 3 4 648 2524 104 38 95.283073 upon
5 1 14 1 3 5 771 2514 104 38 96.237976 each
5 1 14 1 3 6 895 2515 125 36 96.237976 return
5 1 14 1 3 7 1038 2514 111 47 96.884277 visit.)
2 1 15 0 0 0 212 2618 152 65 -1
3 1 15 1 0 0 212 2618 152 65 -1
4 1 15 1 1 0 212 2618 152 65 -1
5 1 15 1 1 1 212 2618 152 65 95.000000
2 1 16 0 0 0 218 2858 1807 52 -1
3 1 16 1 0 0 218 2858 1807 52 -1
4 1 16 1 1 0 218 2858 1807 52 -1
5 1 16 1 1 1 218 2864 163 46 96.085732 Deputy
5 1 16 1 1 2 399 2863 301 37 96.174065 Enforcement
5 1 16 1 1 3 713 2862 141 47 93.030922 Agent
5 1 16 1 1 4 869 2861 31 37 92.875908 &
5 1 16 1 1 5 920 2860 147 47 92.736816 Badge
5 1 16 1 1 6 1084 2860 40 37 92.736816 #:
5 1 16 1 1 7 1159 2860 44 37 95.442284 Lt
5 1 16 1 1 8 1218 2860 190 46 96.805000 Timothy
5 1 16 1 1 9 1425 2859 190 37 96.697456 Rummel
5 1 16 1 1 10 1724 2859 118 36 95.934395 Date:
5 1 16 1 1 11 1861 2858 164 37 96.858826 4/23/16
2 1 17 0 0 0 216 3136 222 30 -1
3 1 17 1 0 0 216 3136 222 30 -1
4 1 17 1 1 0 216 3136 222 30 -1
5 1 17 1 1 1 216 3136 132 30 95.380119 October
5 1 17 1 1 2 360 3137 78 28 95.380119 2015
2 1 18 0 0 0 2543 1176 6 1128 -1
3 1 18 1 0 0 2543 1176 6 1128 -1
4 1 18 1 1 0 2543 1176 6 1128 -1
5 1 18 1 1 1 2543 1176 6 1128 95.000000
Maricopa County Animal Care and Control
2500 S. 27th Avenue
Phoenix, AZ 85009-6797
(602) 506-7387
htto://pets.maricopa.gov
Receipt Number: R16-081900 Receipt Date: 04/08/2016
Person JD: P0829694
Phone: 480 2835048
ERNESTINA PEREZ
4/8/2016 2:25:48PM
9009 S CALLE SAHUARO
GUADALUPE, AZ 85283
Item: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT A7777777 K17-000063 $328.00 4 $328.00
Total Fees Due: $328.00
Payments: Cash: $0.00
Check: $328.00
Credit Card: $0.00
Total Payments Received: $328.00
Thank You!
Would you like to share your experience with our service to you? Change: $0.00
Please visit our website at http://pets.maricopa.gov and click on Balance Due: $0.00
“Contact Us" to email your comments for our review.
Animal Information:
A7777777 KENNEL PERM - BORN 9/14/1999, SPAYED, UNKNOWN/MIX, TRICOLOR DOG
License Information:
Tag Number: License Expires: Animal#¥ Vacc Date: Vacc Expires:
Please retain this receipt with your pet's records
APODACAP EBUSOFF
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VACCINATION RECORD
p RABIES VACCINATION GERTIFIGATE Tag fee $:
Name
ADAPTED NASPHV FORM 57 Tag #:
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4 1 52 1 33 0 195 1959 1469 113 -1
5 1 52 1 33 1 195 2020 126 23 84.925209 SPEGIES:
5 1 52 1 33 2 348 2034 3 2 87.349335 ,
5 1 52 1 33 3 382 2005 22 49 68.304092 |
5 1 52 1 33 4 414 2018 60 24 95.873787 SEX:
5 1 52 1 33 5 634 2002 67 49 96.695328 AGE:
5 1 52 1 33 6 952 2003 68 49 96.715706 SIZE:
5 1 52 1 33 7 1186 2004 15 57 82.798988 |
5 1 52 1 33 8 1190 2019 201 38 95.568069 PREDOMINANT
5 1 52 1 33 9 1399 2019 91 23 89.225365 BREED:
5 1 52 1 33 10 1536 1959 128 113 25.844116 ta
4 1 52 1 34 0 195 2036 1581 85 -1
5 1 52 1 34 1 195 2065 51 29 82.234947 Dog
5 1 52 1 34 2 282 2061 39 33 37.074814 [a
5 1 52 1 34 3 415 2055 61 43 96.785362 Male
5 1 52 1 34 4 577 2058 73 38 16.137600 C14
5 1 52 1 34 5 667 2064 47 23 71.234367 Mo,
5 1 52 1 34 6 729 2065 26 22 90.632584 to
5 1 52 1 34 7 771 2065 30 22 90.632584 12
5 1 52 1 34 8 817 2065 47 22 88.486626 Mo.
5 1 52 1 34 9 894 2059 29 29 71.848389 [J]
5 1 52 1 34 10 940 2064 92 36 92.263901 Under
5 1 52 1 34 11 1041 2065 30 22 96.802048 20
5 1 52 1 34 12 1083 2064 44 23 69.210197 Ibs.
5 1 52 1 34 13 1146 2036 75 52 67.970947 wt
5 1 52 1 34 14 1302 2061 6 45 30.085840 ;
5 1 52 1 34 15 1371 2061 119 60 59.633553 thu.
5 1 52 1 34 16 1575 2056 32 44 0.000000 .
5 1 52 1 34 17 1624 2057 100 48 13.576822 fabs
5 1 52 1 34 18 1738 2053 38 38 84.827667 ry
4 1 52 1 35 0 193 2058 1423 92 -1
5 1 52 1 35 1 193 2112 44 23 59.098427 cat
5 1 52 1 35 2 414 2101 93 42 96.730049 Female
5 1 52 1 35 3 573 2091 50 59 17.303143 fea'|
5 1 52 1 35 4 636 2111 29 31 53.486855 22
5 1 52 1 35 5 678 2110 47 28 96.654160 Mo.
5 1 52 1 35 6 736 2116 26 17 96.734657 or
5 1 52 1 35 7 772 2110 67 23 51.076286 older
5 1 52 1 35 8 951 2097 140 36 27.913618 20-50lbs
5 1 52 1 35 9 1146 2104 29 29 75.140587 O
5 1 52 1 35 10 1194 2058 48 59 72.989304 C
5 1 52 1 35 11 1214 2058 75 57 22.168789 or
5 1 52 1 35 12 1308 2072 62 39 61.441273 We
5 1 52 1 35 13 1573 2065 43 55 24.667210 DD
4 1 52 1 36 0 193 2146 1099 50 -1
5 1 52 1 36 1 193 2158 73 23 89.373566 Other
5 1 52 1 36 2 288 2152 30 28 70.714256 O
5 1 52 1 36 3 411 2157 93 23 28.487129 Altered
5 1 52 1 36 4 951 2157 62 23 96.337234 Over
5 1 52 1 36 5 1021 2157 32 21 58.413246 50
5 1 52 1 36 6 1063 2156 44 24 61.225780 tbs.
5 1 52 1 36 7 1144 2151 37 45 47.063641 {J
5 1 52 1 36 8 1184 2143 15 57 77.470551 |
5 1 52 1 36 9 1203 2151 89 23 96.121727 NAME:
4 1 52 1 37 0 193 2187 1224 90 -1
5 1 52 1 37 1 193 2210 112 67 20.033718 Bpecity)
5 1 52 1 37 2 1191 2187 226 78 49.146389 Peaches
4 1 52 1 38 0 1453 2265 164 15 -1
5 1 52 1 38 1 1453 2271 7 8 25.072708 eo
5 1 52 1 38 2 1495 2267 5 13 10.491638 6
5 1 52 1 38 3 1533 2268 33 12 41.188656 Ey
5 1 52 1 38 4 1600 2265 17 12 24.899040 et
4 1 52 1 39 0 451 2283 1157 27 -1
5 1 52 1 39 1 451 2304 5 5 0.000000 y
5 1 52 1 39 2 727 2304 4 5 0.000000 .
5 1 52 1 39 3 1495 2284 20 19 20.512043 a
5 1 52 1 39 4 1524 2283 32 17 31.137291 a
4 1 52 1 40 0 193 2282 1414 69 -1
5 1 52 1 40 1 193 2299 70 50 91.031357 DATE
5 1 52 1 40 2 271 2298 185 51 59.152409 VACCINATED:
5 1 52 1 40 3 565 2297 172 24 55.255184 PRODUCER.
5 1 52 1 40 4 888 2334 98 17 14.307938 _
5 1 52 1 40 5 1201 2316 172 24 33.483219 Veterinarians
5 1 52 1 40 6 1382 2317 15 22 92.672241 #
5 1 52 1 40 7 1429 2283 50 56 61.874466 é4
5 1 52 1 40 8 1557 2282 50 46 0.852327 tG
4 1 52 1 41 0 214 2326 1340 88 -1
5 1 52 1 41 1 214 2328 56 72 65.534134 2,
5 1 52 1 41 2 348 2340 86 56 58.173111 PE
5 1 52 1 41 3 480 2342 45 49 70.306946 vA
5 1 52 1 41 4 808 2326 50 81 2.232742 3,
5 1 52 1 41 5 870 2349 33 41 76.115097 G
5 1 52 1 41 6 934 2343 52 53 64.421501 al
5 1 52 1 41 7 1404 2348 96 66 0.000000 ene
5 1 52 1 41 8 1510 2343 44 35 95.689423 No.
4 1 52 1 42 0 200 2407 789 41 -1
5 1 52 1 42 1 200 2407 82 23 86.800461 Month
5 1 52 1 42 2 320 2403 14 50 45.500671 =
5 1 52 1 42 3 349 2408 50 28 45.500671 Day
5 1 52 1 42 4 463 2407 58 23 11.335793 Year
5 1 52 1 42 5 797 2418 87 29 95.558281 (First
5 1 52 1 42 6 872 2402 13 50 96.236626 3
5 1 52 1 42 7 894 2419 95 29 96.421860 Letters)
2 1 53 0 0 0 189 2508 324 93 -1
3 1 53 1 0 0 189 2508 324 93 -1
4 1 53 1 1 0 189 2508 324 48 -1
5 1 53 1 1 1 189 2509 189 23 93.511673 VACCINATION
5 1 53 1 1 2 390 2508 123 48 96.477821 EXPIRES:
4 1 53 1 2 0 201 2553 275 48 -1
5 1 53 1 2 1 201 2559 47 42 44.641579 A
5 1 53 1 2 2 330 2551 86 43 40.755726 26
5 1 53 1 2 3 474 2556 2 3 49.754395 |
2 1 54 0 0 0 561 2474 281 133 -1
3 1 54 1 0 0 561 2474 263 96 -1
4 1 54 1 1 0 564 2474 224 34 -1
5 1 54 1 1 1 564 2481 9 21 90.761307 1
5 1 54 1 1 2 586 2485 28 23 87.661125 yr.
5 1 54 1 1 3 625 2479 41 23 36.789394 Lic.
5 1 54 1 1 4 669 2477 114 27 35.643997 Wace.
5 1 54 1 1 5 761 2470 30 44 40.802521 Py
4 1 54 1 2 0 561 2535 281 72 -1
5 1 54 1 2 1 561 2542 15 22 76.995323 3
5 1 54 1 2 2 585 2547 27 23 76.995323 yr.
5 1 54 1 2 3 624 2541 42 23 0.000000 Lic.
5 1 54 1 2 4 667 2541 80 23 0.000000 Wace.
5 1 54 1 2 5 756 2535 29 29 20.066837 TJ
5 1 54 1 2 6 814 2539 28 68 43.897232 q
2 1 55 0 0 0 171 2594 374 18 -1
3 1 55 1 0 0 171 2594 374 18 -1
4 1 55 1 1 0 171 2594 374 18 -1
5 1 55 1 1 1 171 2594 374 18 95.000000
2 1 56 0 0 0 190 2613 80 24 -1
3 1 56 1 0 0 190 2613 80 24 -1
4 1 56 1 1 0 190 2613 80 24 -1
5 1 56 1 1 1 190 2613 80 24 96.565125 Month
2 1 57 0 0 0 164 1624 30 1093 -1
3 1 57 1 0 0 164 1624 30 1093 -1
4 1 57 1 1 0 164 1624 30 1093 -1
5 1 57 1 1 1 164 1624 30 1093 95.000000
2 1 58 0 0 0 348 2613 48 29 -1
3 1 58 1 0 0 348 2613 48 29 -1
4 1 58 1 1 0 348 2613 48 29 -1
5 1 58 1 1 1 348 2613 48 29 96.939148 Day
2 1 59 0 0 0 462 2613 57 23 -1
3 1 59 1 0 0 462 2613 57 23 -1
4 1 59 1 1 0 462 2613 57 23 -1
5 1 59 1 1 1 462 2613 57 23 96.569122 Year
2 1 60 0 0 0 882 2519 192 78 -1
3 1 60 1 0 0 882 2519 192 78 -1
4 1 60 1 1 0 882 2519 192 78 -1
5 1 60 1 1 1 882 2518 192 79 30.540152 DNS
5 1 60 1 1 2 1033 2514 38 110 92.113976 A
2 1 61 0 0 0 794 2618 336 15 -1
3 1 61 1 0 0 794 2618 336 15 -1
4 1 61 1 1 0 794 2618 336 15 -1
5 1 61 1 1 1 794 2618 336 15 95.000000
2 1 62 0 0 0 538 2279 15 436 -1
3 1 62 1 0 0 538 2279 15 436 -1
4 1 62 1 1 0 538 2279 15 436 -1
5 1 62 1 1 1 538 2279 15 436 95.000000
2 1 63 0 0 0 793 2646 269 29 -1
3 1 63 1 0 0 793 2646 269 29 -1
4 1 63 1 1 0 793 2646 269 29 -1
5 1 63 1 1 1 793 2646 70 23 87.989159 Vacc.
5 1 63 1 1 2 873 2646 71 23 69.468903 Serial
5 1 63 1 1 3 954 2646 54 29 94.592232 (Lot)
5 1 63 1 1 4 1020 2646 42 23 96.165001 No.
2 1 64 0 0 0 1514 1803 18 519 -1
3 1 64 1 0 0 1514 1803 18 519 -1
4 1 64 1 1 0 1514 1803 18 519 -1
5 1 64 1 1 1 1514 1803 18 519 95.000000
2 1 65 0 0 0 1404 2330 483 22 -1
3 1 65 1 0 0 1404 2330 483 22 -1
4 1 65 1 1 0 1404 2330 483 22 -1
5 1 65 1 1 1 1404 2330 483 22 95.000000
2 1 66 0 0 0 1183 2399 728 29 -1
3 1 66 1 0 0 1183 2399 728 29 -1
4 1 66 1 1 0 1183 2399 728 29 -1
5 1 66 1 1 1 1183 2399 728 29 95.000000
2 1 67 0 0 0 1171 2388 372 190 -1
3 1 67 1 0 0 1171 2388 380 190 -1
4 1 67 1 1 0 1171 2388 372 190 -1
5 1 67 1 1 1 1171 2463 4 5 10.819921 :
5 1 67 1 1 2 1200 2388 343 190 43.267406 =)
4 1 67 1 2 0 1200 2494 123 28 -1
5 1 67 1 2 1 1200 2494 123 28 96.747681 Signature
2 1 68 0 0 0 1329 2506 555 24 -1
3 1 68 1 0 0 1329 2506 555 24 -1
4 1 68 1 1 0 1329 2506 555 24 -1
5 1 68 1 1 1 1329 2506 555 24 95.000000
2 1 69 0 0 0 1198 2554 107 23 -1
3 1 69 1 0 0 1198 2554 107 23 -1
4 1 69 1 1 0 1198 2554 107 23 -1
5 1 69 1 1 1 1198 2554 107 23 96.156113 Address
2 1 70 0 0 0 1312 2566 569 25 -1
3 1 70 1 0 0 1312 2566 569 25 -1
4 1 70 1 1 0 1312 2566 569 25 -1
5 1 70 1 1 1 1312 2566 569 25 95.000000
2 1 71 0 0 0 1455 2533 32 64 -1
3 1 71 1 0 0 1455 2533 32 64 -1
4 1 71 1 1 0 1455 2533 32 64 -1
5 1 71 1 1 1 1455 2533 32 64 76.694244 \
2 1 72 0 0 0 1522 2520 25 75 -1
3 1 72 1 0 0 1522 2520 25 75 -1
4 1 72 1 1 0 1522 2520 25 75 -1
5 1 72 1 1 1 1522 2520 25 75 76.963150 }
2 1 73 0 0 0 1309 2628 571 24 -1
3 1 73 1 0 0 1309 2628 571 24 -1
4 1 73 1 1 0 1309 2628 571 24 -1
5 1 73 1 1 1 1309 2628 571 24 95.000000
2 1 74 0 0 0 1173 2001 25 715 -1
3 1 74 1 0 0 1173 2001 25 715 -1
4 1 74 1 1 0 1173 2001 25 715 -1
5 1 74 1 1 1 1173 2001 25 715 95.000000
2 1 75 0 0 0 1363 2643 205 56 -1
3 1 75 1 0 0 1363 2643 205 56 -1
4 1 75 1 1 0 1363 2643 205 56 -1
5 1 75 1 1 1 1363 2652 50 44 71.157211 V
5 1 75 1 1 2 1429 2643 139 56 40.129097 RCE
2 1 76 0 0 0 1618 2643 157 59 -1
3 1 76 1 0 0 1618 2643 157 59 -1
4 1 76 1 1 0 1618 2643 157 59 -1
5 1 76 1 1 1 1618 2643 157 59 45.141445 oS
2 1 77 0 0 0 1898 1623 32 1092 -1
3 1 77 1 0 0 1898 1623 32 1092 -1
4 1 77 1 1 0 1898 1623 32 1092 -1
5 1 77 1 1 1 1898 1623 32 1092 95.000000
2 1 78 0 0 0 169 2680 1739 65 -1
3 1 78 1 0 0 169 2680 1739 65 -1
4 1 78 1 1 0 169 2680 1739 65 -1
5 1 78 1 1 1 169 2680 1739 65 95.000000
2 1 79 0 0 0 169 2722 166 31 -1
3 1 79 1 0 0 169 2722 166 31 -1
4 1 79 1 1 0 169 2722 166 31 -1
5 1 79 1 1 1 169 2722 166 31 28.216915 VAC0410004
2 1 80 0 0 0 2011 111 479 953 -1
3 1 80 1 0 0 2028 111 360 27 -1
4 1 80 1 1 0 2028 111 360 27 -1
5 1 80 1 1 1 2028 112 213 26 93.215576 VACCINATION
5 1 80 1 1 2 2254 111 134 27 91.912888 REGORD
3 1 80 2 0 0 2028 160 86 26 -1
4 1 80 2 1 0 2028 160 86 26 -1
5 1 80 2 1 1 2028 160 86 26 96.668777 Name
3 1 80 3 0 0 2025 214 155 28 -1
4 1 80 3 1 0 2025 214 155 28 -1
5 1 80 3 1 1 2025 214 155 28 37.503757 CORABIES
3 1 80 4 0 0 2023 268 269 29 -1
4 1 80 4 1 0 2023 268 269 29 -1
5 1 80 4 1 1 2023 268 124 29 34.715836 (CULYME
5 1 80 4 1 2 2158 270 134 26 95.090065 DISEASE
3 1 80 5 0 0 2023 324 353 29 -1
4 1 80 5 1 0 2023 324 353 29 -1
5 1 80 5 1 1 2023 324 160 29 64.594879 CICANINE
5 1 80 5 1 2 2194 325 182 26 91.715363 DISTEMPER
3 1 80 6 0 0 2022 379 432 28 -1
4 1 80 6 1 0 2022 379 432 28 -1
5 1 80 6 1 1 2022 379 159 28 66.160622 CICANINE
5 1 80 6 1 2 2194 381 260 26 92.591812 PARAINFLUENZA
3 1 80 7 0 0 2020 421 467 41 -1
4 1 80 7 1 0 2020 421 467 41 -1
5 1 80 7 1 1 2020 433 161 29 84.145050 CICANINE
5 1 80 7 1 2 2190 436 209 26 76.079613 ADENOVIRUS
5 1 80 7 1 3 2409 421 78 41 11.972942 2
3 1 80 8 0 0 2020 489 373 29 -1
4 1 80 8 1 0 2020 489 373 29 -1
5 1 80 8 1 1 2020 489 161 29 35.351860 CICANINE
5 1 80 8 1 2 2191 492 202 26 95.896278 PARVOVIRUS
3 1 80 9 0 0 2019 544 405 29 -1
4 1 80 9 1 0 2019 544 405 29 -1
5 1 80 9 1 1 2019 544 30 29 44.731522 CI
5 1 80 9 1 2 2058 547 122 26 44.731522 CANINE
5 1 80 9 1 3 2190 546 234 27 63.846748 CORONAVIRUS
3 1 80 10 0 0 2019 600 380 29 -1
4 1 80 10 1 0 2019 600 380 29 -1
5 1 80 10 1 1 2019 600 29 29 59.672867 CU
5 1 80 10 1 2 2056 603 122 26 70.190598 CANINE
5 1 80 10 1 3 2190 601 209 28 96.411880 BORDETELLA
3 1 80 11 0 0 2017 655 293 29 -1
4 1 80 11 1 0 2017 655 293 29 -1
5 1 80 11 1 1 2017 655 29 29 64.970535 (J
5 1 80 11 1 2 2056 657 254 27 70.299667 LEPTOSPIROSIS
3 1 80 12 0 0 2016 700 425 40 -1
4 1 80 12 1 0 2016 700 425 40 -1
5 1 80 12 1 1 2016 711 30 29 48.930378 C]
5 1 80 12 1 2 2056 712 109 26 95.271278 FELINE
5 1 80 12 1 3 2176 713 163 25 96.920952 LEUKEMIA
5 1 80 12 1 4 2346 700 95 38 91.788620 VIRUS
3 1 80 13 0 0 2016 766 425 28 -1
4 1 80 13 1 0 2016 766 425 28 -1
5 1 80 13 1 1 2016 766 147 28 54.307487 COFELINE
5 1 80 13 1 2 2175 768 266 26 91.419174 PANLEUKOPENIA
3 1 80 14 0 0 2014 821 449 28 -1
4 1 80 14 1 0 2014 821 449 28 -1
5 1 80 14 1 1 2014 821 149 28 0.000000 CIFELINE
5 1 80 14 1 2 2175 823 288 26 90.333931 RHINOTRACHEITIS
3 1 80 15 0 0 2013 876 359 29 -1
4 1 80 15 1 0 2013 876 359 29 -1
5 1 80 15 1 1 2013 876 149 29 43.028942 CIFELINE
5 1 80 15 1 2 2173 879 199 26 86.455551 CALICIVIRUS
3 1 80 16 0 0 2013 931 348 29 -1
4 1 80 16 1 0 2013 931 348 29 -1
5 1 80 16 1 1 2013 931 149 29 45.285210 OOFELINE
5 1 80 16 1 2 2172 934 189 26 96.426147 CHLAMYDIA
3 1 80 17 0 0 2011 987 479 77 -1
4 1 80 17 1 0 2011 987 479 29 -1
5 1 80 17 1 1 2011 987 31 29 13.908405 (1
5 1 80 17 1 2 2052 990 108 26 86.982422 FELINE
5 1 80 17 1 3 2172 990 318 26 6.766481 IMMUNODEFICIENCY
4 1 80 17 2 0 2050 1038 95 26 -1
5 1 80 17 2 1 2050 1038 95 26 96.617516 VIRUS
2 1 81 0 0 0 2123 180 331 14 -1
3 1 81 1 0 0 2123 180 331 14 -1
4 1 81 1 1 0 2123 180 331 14 -1
5 1 81 1 1 1 2123 180 331 14 95.000000
2 1 82 0 0 0 2070 1138 254 82 -1
3 1 82 1 0 0 2070 1138 254 82 -1
4 1 82 1 1 0 2140 1138 184 40 -1
5 1 82 1 1 1 2140 1138 184 40 96.576431 Boehringer
4 1 82 1 2 0 2070 1146 237 74 -1
5 1 82 1 2 1 2070 1146 36 71 33.398468 ii
5 1 82 1 2 2 2141 1180 166 40 85.089973 Ingelheim
2 1 83 0 0 0 1998 1624 482 958 -1
3 1 83 1 0 0 2012 1624 361 26 -1
4 1 83 1 1 0 2012 1624 361 26 -1
5 1 83 1 1 1 2012 1624 214 26 96.145119 VACCINATION
5 1 83 1 1 2 2238 1624 135 26 96.289803 RECORD
3 1 83 2 0 0 2013 1674 84 26 -1
4 1 83 2 1 0 2013 1674 84 26 -1
5 1 83 2 1 1 2013 1674 84 26 95.500381 Name
3 1 83 3 0 0 2009 1728 154 29 -1
4 1 83 3 1 0 2009 1728 154 29 -1
5 1 83 3 1 1 2009 1728 30 29 59.888569 CY
5 1 83 3 1 2 2049 1731 114 26 59.888569 RABIES
3 1 83 4 0 0 2008 1783 269 29 -1
4 1 83 4 1 0 2008 1783 269 29 -1
5 1 83 4 1 1 2008 1783 122 29 91.196869 LILYME
5 1 83 4 1 2 2142 1785 135 26 95.585533 DISEASE
3 1 83 5 0 0 2007 1837 354 29 -1
4 1 83 5 1 0 2007 1837 354 29 -1
5 1 83 5 1 1 2007 1837 30 29 62.461449 CJ]
5 1 83 5 1 2 2046 1841 120 25 91.730141 CANINE
5 1 83 5 1 3 2179 1840 182 26 91.584106 DISTEMPER
3 1 83 6 0 0 2007 1893 432 29 -1
4 1 83 6 1 0 2007 1893 432 29 -1
5 1 83 6 1 1 2007 1893 29 29 56.457344 C)
5 1 83 6 1 2 2045 1896 121 26 93.282471 CANINE
5 1 83 6 1 3 2178 1896 261 26 92.016754 PARAINFLUENZA
3 1 83 7 0 0 2005 1948 406 29 -1
4 1 83 7 1 0 2005 1948 406 29 -1
5 1 83 7 1 1 2005 1948 31 29 70.286499 CLI
5 1 83 7 1 2 2044 1951 122 26 76.941956 CANINE
5 1 83 7 1 3 2175 1951 209 26 96.510429 ADENOVIRUS
5 1 83 7 1 4 2395 1953 16 24 96.414009 2
3 1 83 8 0 0 2005 2004 373 29 -1
4 1 83 8 1 0 2005 2004 373 29 -1
5 1 83 8 1 1 2005 2004 29 29 67.571136 [1
5 1 83 8 1 2 2043 2007 122 26 95.636200 CANINE
5 1 83 8 1 3 2176 2007 202 26 96.416954 PARVOVIRUS
3 1 83 9 0 0 2004 2059 405 40 -1
4 1 83 9 1 0 2004 2059 405 40 -1
5 1 83 9 1 1 2004 2059 29 29 6.095276 C
5 1 83 9 1 2 2043 2062 120 37 54.223587 GANINE
5 1 83 9 1 3 2175 2062 234 26 95.957466 CORONAVIRUS
3 1 83 10 0 0 2004 2115 380 32 -1
4 1 83 10 1 0 2004 2115 380 32 -1
5 1 83 10 1 1 2004 2115 29 29 23.124399 C1)
5 1 83 10 1 2 2041 2118 122 26 88.112366 CANINE
5 1 83 10 1 3 2175 2118 209 29 96.273766 BORDETELLA
3 1 83 11 0 0 2002 2170 293 29 -1
4 1 83 11 1 0 2002 2170 293 29 -1
5 1 83 11 1 1 2002 2170 293 29 0.000000 (ILEPTOSPIROSIS
3 1 83 12 0 0 2002 2226 425 29 -1
4 1 83 12 1 0 2002 2226 425 29 -1
5 1 83 12 1 1 2002 2226 148 29 6.793499 (FELINE
5 1 83 12 1 2 2161 2229 161 26 95.902359 LEUKEMIA
5 1 83 12 1 3 2331 2229 96 26 94.866852 VIRUS
3 1 83 13 0 0 2001 2282 426 30 -1
4 1 83 13 1 0 2001 2282 426 30 -1
5 1 83 13 1 1 2001 2282 29 28 44.179302 (J
5 1 83 13 1 2 2040 2284 108 26 93.141113 FELINE
5 1 83 13 1 3 2160 2284 267 28 90.849617 PANLEUKOPENIA
3 1 83 14 0 0 1999 2338 449 29 -1
4 1 83 14 1 0 1999 2338 449 29 -1
5 1 83 14 1 1 1999 2338 31 28 51.312679 CI
5 1 83 14 1 2 2040 2340 108 26 59.482273 FELINE
5 1 83 14 1 3 2160 2340 288 27 91.572617 RHINOTRACHEITIS
3 1 83 15 0 0 1999 2394 358 29 -1
4 1 83 15 1 0 1999 2394 358 29 -1
5 1 83 15 1 1 1999 2394 29 29 60.935951 (C1
5 1 83 15 1 2 2038 2397 109 26 68.993584 FELINE
5 1 83 15 1 3 2158 2395 199 26 90.635544 CALICIVIRUS
3 1 83 16 0 0 1999 2449 349 29 -1
4 1 83 16 1 0 1999 2449 349 29 -1
5 1 83 16 1 1 1999 2449 29 28 55.254395 CI
5 1 83 16 1 2 2038 2452 109 26 55.254395 FELINE
5 1 83 16 1 3 2158 2451 190 27 95.600311 CHLAMYDIA
3 1 83 17 0 0 1998 2505 482 77 -1
4 1 83 17 1 0 1998 2505 482 29 -1
5 1 83 17 1 1 1998 2505 147 29 43.214054 LIFELINE
5 1 83 17 1 2 2158 2506 322 26 95.636833 IMMUNODEFICIENCY
4 1 83 17 2 0 2037 2556 95 26 -1
5 1 83 17 2 1 2037 2556 95 26 95.898964 VIRUS
2 1 84 0 0 0 2106 1692 333 17 -1
3 1 84 1 0 0 2106 1692 333 17 -1
4 1 84 1 1 0 2106 1692 333 17 -1
5 1 84 1 1 1 2106 1692 333 17 95.000000
2 1 85 0 0 0 2470 1948 5 8 -1
3 1 85 1 0 0 2470 1948 5 8 -1
4 1 85 1 1 0 2470 1948 5 8 -1
5 1 85 1 1 1 2470 1948 5 8 0.000000 f
2 1 86 0 0 0 2056 2655 254 81 -1
3 1 86 1 0 0 2064 2655 246 81 -1
4 1 86 1 1 0 2127 2655 183 39 -1
5 1 86 1 1 1 2127 2655 183 39 90.539520 Boehringer
4 1 86 1 2 0 2056 2663 238 73 -1
5 1 86 1 2 1 2056 2663 35 70 56.024090 il
5 1 86 1 2 2 2127 2697 167 39 90.273865 Ingelheim
2 1 87 0 0 0 2487 6 63 3279 -1
3 1 87 1 0 0 2487 6 63 3279 -1
4 1 87 1 1 0 2487 6 63 3279 -1
5 1 87 1 1 1 2487 6 63 3279 95.000000 Span
VACGINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $:
Name
ADAPTED NASPHV FORM 57 Tag #:
DO RABIES
Owner's Name & Address PRINT - use ball point pen or type Cart, Serial #:
CULYME DISEASE
Ry LAST ~FIRST.. 3 | Mi » TEEEPHONE eI : (3 CANINE DISTEMPER
Pex Cp. 5 ne USING if cart pyre HOD IRA CPA LY FOE mt
CL] CANINE PARAINFLUENZA
ZIP
Foca : way He SOV WUOKO Quy en Volta NOT AF, Na cpemejecnety CI CANINE ADENOVIRUS 2 £
4 CU UO CONUDE,
SSRI
\ CLI CANINE PARVOVIRUS
SPECIES: SEX: SIZE: PREDOMINANT BREED:
Dog 74. | Male rin 3 Wo to 12 Mo, ©] Under 20 Ibs. SEL) £4 Bic OAL. CJ CANINE CORONAVIRUS
(i i WUC. UG. A
cat OO Female [J] 12Mo.orolder p@f]20-50bs 0 [2 CANINE BORDETELLA
Other [) wae aus Over 50 Ibs. (] | NAME:
C) LEPTOSPIROSIS
(Specify) Od@© ; ( FELINE LEUKEMIA VIRUS
DATE | PRODUGER:, Ay CI FELINE PANLEUKOPENIA
Veterinarlan's # A LO
DVO) i; ee ao CI FELINE RHINOTRACHEITIS
ol
te (J FELINE CALICIVIRUS
ay Ye ‘ear (First 3 Letters) we
Veter ais f iz
; ] OO FELINE CHLAMYDIA
1 ye. Lic. Wace at : .
EXPIRES; Signature {3 FELINE IMMUNODEFICIENCY
RONSON lan mS i “a 28 yt Lie.Wace. OI , : VIRUS
- a aa LICOU (é a ” ‘ese ' fa e
Month Day Year a wa Wier ox A iS
“Serial {Lot) No. anol
Boehringer
ih Ingelheim
VAC0410001
VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $:
Name
ADAPTED NASPHV FORM 517 Tag #:
LJ RABIES
Owner’s Name & Address PRINT - use ball point pen or type Cert. Serial #:
LILYME DISEASE
INT LAST FIRST. botin. Mi AE HONE =, ao L) CANINE DISTEMPER
CJ] CANINE PARAINFLUENZA
Boca # ecalle hwalo PquadgWPe STATE ‘ZB, OD 76 Sd —_ 8
CE Ax, - CI CANINE ADENOVIRUS 2
3
SPECIES: |SEX: AGE: SIZE: PREDOMINANT BREED: COLORS: CI CANINE PARVOVIRUS
_
Dog &” Male (| 3 Mo, to 12 Mo, [1] Under 20 Ibs. 1) Ch CK Pa Lahr té L) CANINE CORONAVIRUS
\
cat Of Female (J{12Mo.orolder (0) 20-50lbs [| we CICANINE BORDETELLA
Other Altered OO Over 50 Ibs. NAME: \ A et loud LJ LEPTOSPIROSIS
(Specify) 5 Ssfervi mo 3 ~
ar (1 FELINE LEUKEMIA VIRUS
VACCINATED: . PRODUGER: . Teb fi’ C) FELINE PANLEUKOPENIA
oe , -5 4, Veterinarian’s # gah
- wy tf i a) E ke coke Ni (J) FELINE RHINOTRACHEITIS
> Lo | & O a
Month D ay Year ; i (1 FELINE CALICIVIRUS
ort (First 3 Letters} Veterinaran’s”
;
| 7 (4 FELINE CHLAMYDIA
1 * yr. Lic.Vace. fv) . i
VACCINATION EXPIRES: Signature aoe ©) FELINE IMMUNODEFICIENCY
4 3 yr, yr, Lic. Lic. Vace, Vac FJ Address VIRUS
ISA
ISO
Month Day Year
Vacc. Serial (Lot) No.
Niet C3 aI” Boehringer
ii
i Ingelheim
VAC0410001
: RABIES VACCINATION CERTIFICATE Tag fee $:
ADAPTED NASPHV FORM 57 Tag #:
Owner’s Name & Address PRINT - use balf point pen or type Cert. Serial #:
FIRST A Mi
MeaNed? Brinishina UA Bere TA BOR
“net 2
Boost i bee
myc c re ney Cunnalbae f ir aie eg
SS COME, SOUCVO | PEIG
SPECIES: SEX: AGE: SIZE: PREDOMINANT BREED: | COLORS:
,
Dog Yat Male [1] 3 Mo. to 12 Mo, O| Under 20 tbs. Us. ae
Cy ¥ nud puck Ane,
cat 0 Female at 12 Mo. or older “Z| 20-50 lbs ‘a
Other Altered WF 4 Over 50 tbs. [7} NAME:
(Specify)
al AION,
DATE VACCINATED: PRODUCER: he. (A (GO
rom Veterinarian’s ei 4M
B 9O j IG, . By ae P)
WES A Pt va
=< or
Month on =D ay Ye ear (First 3 Letiers)
Veterinarian’s.¥ _
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ran :
Month Day Year His Wi ont ‘.) Ay IS
Serial (Lon
. No.
VAC0410001
RABIES VACCINATION CERTIFICATE Tag fee $:
ADAPTED NASPHV FORM 51 Tag #:
Qwner's Name & Address PRINT - use ball point pen or type Cert. Serial #:
PRINT LAST RST oe MI ELEPHONE
Er AISTAC Ve 53 soug
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NO, CITY STATE ZIPP ES.
Avg xs calle Sah uve Guadalupe, Ve. €S7 £3
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SPECIES; SEX: |
5 1 68 3 2 6 967 1996 65 23 96.132156 SIZE:
5 1 68 3 2 7 1158 2027 39 39 0.000000 ¥
5 1 68 3 2 8 1223 1980 171 51 96.483307 PREDOMINANT
5 1 68 3 2 9 1411 1980 91 51 96.723618 BREED:
5 1 68 3 2 10 1548 1981 129 74 26.670408 COLORS:
4 1 68 3 3 0 210 2012 1514 73 -1
5 1 68 3 3 1 210 2043 50 29 96.657089 Dag
5 1 68 3 3 2 296 2012 49 73 8.008776 ra
5 1 68 3 3 3 427 2027 62 50 96.402313 Male
5 1 68 3 3 4 648 2043 15 21 93.949608 3
5 1 68 3 3 5 679 2042 47 22 90.074242 Mo,
5 1 68 3 3 6 743 2043 25 21 95.757050 to
5 1 68 3 3 7 784 2043 31 21 95.469795 12
5 1 68 3 3 8 832 2042 46 22 87.479744 Mo.
5 1 68 3 3 9 906 2036 30 28 36.099586 C1]
5 1 68 3 3 10 953 2041 91 32 54.091564 Under
5 1 68 3 3 11 1053 2043 32 21 93.512161 20
5 1 68 3 3 12 1096 2043 43 23 92.050682 Ibs.
5 1 68 3 3 13 1248 2043 30 36 39.494522 “in
5 1 68 3 3 14 1344 2047 99 37 0.000000 hutlio
5 1 68 3 3 15 1462 2055 28 27 9.875088 cd
5 1 68 3 3 16 1614 2035 110 46 49.086704 iad
4 1 68 3 4 0 208 2031 1532 100 -1
5 1 68 3 4 1 208 2089 44 23 79.038452 Cat
5 1 68 3 4 2 300 2083 29 29 0.000000 (|
5 1 68 3 4 3 426 2088 95 23 0.000000 Female
5 1 68 3 4 4 589 2082 29 29 42.215805 1}
5 1 68 3 4 5 633 2088 45 43 68.309486 12
5 1 68 3 4 6 691 2088 47 27 68.309486 Mo.
5 1 68 3 4 7 750 2093 26 18 39.200726 or
5 1 68 3 4 8 786 2082 66 29 39.200726 older
5 1 68 3 4 9 906 2082 38 29 39.761337 Hf
5 1 68 3 4 10 964 2088 140 23 34.758686 20-sobs
5 1 68 3 4 11 1158 2083 29 29 26.218380 C3
5 1 68 3 4 12 1215 2045 182 49 0.000000 Cinirual
5 1 68 3 4 13 1405 2056 58 67 47.521301 We
5 1 68 3 4 14 1560 2031 61 97 37.619209 ay)
5 1 68 3 4 15 1716 2058 24 29 0.000000 “
4 1 68 3 5 0 207 2123 1497 60 -1
5 1 68 3 5 1 207 2134 72 23 17.650709 Other
5 1 68 3 5 2 419 2123 97 43 96.392075 Altered
5 1 68 3 5 3 964 2134 61 23 96.570557 Over
5 1 68 3 5 4 1033 2136 32 21 90.352943 50
5 1 68 3 5 5 1077 2136 42 23 90.352943 Ibs.
5 1 68 3 5 6 1156 2130 29 29 41.302727 (J
5 1 68 3 5 7 1198 2124 8 44 41.302727 {
5 1 68 3 5 8 1215 2128 87 23 96.511932 NAME:
5 1 68 3 5 9 1593 2124 9 50 85.657135 i
5 1 68 3 5 10 1615 2131 40 41 51.968784 ce
5 1 68 3 5 11 1663 2127 41 56 44.035267 i}
4 1 68 3 6 0 208 2172 1277 62 -1
5 1 68 3 6 1 208 2172 110 56 94.696510 (Specify)
5 1 68 3 6 2 1209 2182 86 52 0.000000 Aba
5 1 68 3 6 3 1311 2184 174 47 0.000000 PIV)
4 1 68 3 7 0 207 2256 1383 63 -1
5 1 68 3 7 1 207 2275 69 23 93.217529 DATE
5 1 68 3 7 2 285 2275 192 26 52.350990 VACCINATED:.
5 1 68 3 7 3 577 2256 173 52 74.521667 PRODUCER:.
5 1 68 3 7 4 1213 2294 172 24 20.471577 Veterinarian’
5 1 68 3 7 5 1393 2295 16 23 90.997185 #
5 1 68 3 7 6 1468 2265 11 54 50.820831 i
5 1 68 3 7 7 1558 2262 32 56 40.907181 (
3 1 68 4 0 0 202 2307 1483 312 -1
4 1 68 4 1 0 240 2307 1355 90 -1
5 1 68 4 1 1 240 2307 35 57 87.130974 3
5 1 68 4 1 2 327 2323 84 44 40.216583 WO
5 1 68 4 1 3 498 2325 12 20 0.000000 £
5 1 68 4 1 4 835 2323 31 57 71.525299 R
5 1 68 4 1 5 889 2328 28 47 63.152538 6
5 1 68 4 1 6 952 2319 35 51 90.667068 E
5 1 68 4 1 7 1410 2308 102 75 85.247169 License
5 1 68 4 1 8 1532 2317 63 80 42.027199 on
4 1 68 4 2 0 214 2381 1381 115 -1
5 1 68 4 2 1 214 2384 80 24 75.098015 Month
5 1 68 4 2 2 328 2379 15 57 64.783699 =
5 1 68 4 2 3 363 2385 48 27 66.719727 Day
5 1 68 4 2 4 475 2383 59 23 21.938467 Year
5 1 68 4 2 5 810 2397 86 27 95.615097 (First
5 1 68 4 2 6 886 2379 11 57 93.842506 3
5 1 68 4 2 7 907 2397 94 29 85.287254 Letters)
5 1 68 4 2 8 1212 2381 171 61 62.765305 Veterinarian’s
5 1 68 4 2 9 1404 2396 191 100 25.970303 tT
4 1 68 4 3 0 202 2426 1342 92 -1
5 1 68 4 3 1 202 2486 188 24 88.389687 VACCINATION
5 1 68 4 3 2 402 2485 123 23 26.249599 EXPIRES:
5 1 68 4 3 3 553 2459 17 61 58.849430 |
5 1 68 4 3 4 708 2463 47 17 40.691448 aco
5 1 68 4 3 5 765 2426 38 92 4.762907 fh
5 1 68 4 3 6 1211 2472 123 29 96.979584 Signature
5 1 68 4 3 7 1453 2430 12 66 87.768799 |
5 1 68 4 3 8 1522 2487 22 9 43.708359 zs
4 1 68 4 4 0 216 2495 1307 104 -1
5 1 68 4 4 1 216 2525 39 54 68.016785 2
5 1 68 4 4 2 330 2532 25 47 22.651825 a
5 1 68 4 4 3 384 2524 30 53 79.228355 6
5 1 68 4 4 4 523 2544 12 33 82.841705 }
5 1 68 4 4 5 549 2517 3 3 27.810564 |)
5 1 68 4 4 6 573 2519 14 22 62.622364 3
5 1 68 4 4 7 597 2524 27 23 62.622364 yr.
5 1 68 4 4 8 636 2518 123 23 58.084076 LicVaee,
5 1 68 4 4 9 889 2543 26 49 69.333099 ¢
5 1 68 4 4 10 958 2508 57 91 52.041050 Hy
5 1 68 4 4 11 1036 2544 49 51 0.000000 r
5 1 68 4 4 12 1209 2532 107 23 91.200417 Address
5 1 68 4 4 13 1438 2495 85 56 65.066917 od
4 1 68 4 5 0 202 2539 1483 86 -1
5 1 68 4 5 1 202 2579 82 44 96.223137 Month
5 1 68 4 5 2 358 2591 50 28 94.481255 Day
5 1 68 4 5 3 472 2590 58 23 69.383911 Year
5 1 68 4 5 4 831 2539 57 85 72.277283 at
5 1 68 4 5 5 919 2553 31 44 82.484283 0
5 1 68 4 5 6 982 2592 8 8 8.485451 :
5 1 68 4 5 7 1017 2549 21 45 91.381630 5
5 1 68 4 5 8 1360 2577 43 40 64.902710 iA
5 1 68 4 5 9 1399 2567 112 58 37.542526 etld
5 1 68 4 5 10 1569 2572 33 45 65.587242 3
5 1 68 4 5 11 1609 2568 38 48 91.630074 5
5 1 68 4 5 12 1657 2560 28 53 15.415802 S
3 1 68 5 0 0 807 2621 636 31 -1
4 1 68 5 1 0 807 2621 636 31 -1
5 1 68 5 1 1 807 2623 68 23 35.467205 Vace.
5 1 68 5 1 2 885 2623 71 23 93.267227 Serial
5 1 68 5 1 3 966 2624 54 28 90.204559 (Lot}
5 1 68 5 1 4 1030 2624 43 22 96.413506 No.
5 1 68 5 1 5 1440 2621 3 6 40.219032 :
2 1 69 0 0 0 1910 1602 31 1092 -1
3 1 69 1 0 0 1910 1602 31 1092 -1
4 1 69 1 1 0 1910 1602 31 1092 -1
5 1 69 1 1 1 1910 1602 31 1092 95.000000
2 1 70 0 0 0 183 2656 1734 71 -1
3 1 70 1 0 0 183 2656 1734 71 -1
4 1 70 1 1 0 183 2656 1734 71 -1
5 1 70 1 1 1 183 2656 1734 71 95.000000
2 1 71 0 0 0 183 2707 164 23 -1
3 1 71 1 0 0 183 2707 164 23 -1
4 1 71 1 1 0 183 2707 164 23 -1
5 1 71 1 1 1 183 2707 164 23 67.482620 VAC0410001
2 1 72 0 0 0 2046 111 453 956 -1
3 1 72 1 0 0 2067 111 360 27 -1
4 1 72 1 1 0 2067 111 360 27 -1
5 1 72 1 1 1 2067 111 213 27 96.390732 VACCINATION
5 1 72 1 1 2 2293 112 134 26 95.709602 RECORD
3 1 72 2 0 0 2067 160 86 26 -1
4 1 72 2 1 0 2067 160 86 26 -1
5 1 72 2 1 1 2067 160 86 26 92.794006 Narne
3 1 72 3 0 0 2063 214 154 29 -1
4 1 72 3 1 0 2063 214 154 29 -1
5 1 72 3 1 1 2063 214 154 29 17.253246 FURABIES
3 1 72 4 0 0 2062 270 268 29 -1
4 1 72 4 1 0 2062 270 268 29 -1
5 1 72 4 1 1 2062 270 122 29 87.060600 LILYME
5 1 72 4 1 2 2196 273 134 24 96.429375 DISEASE
3 1 72 5 0 0 2061 325 351 29 -1
4 1 72 5 1 0 2061 325 351 29 -1
5 1 72 5 1 1 2061 325 29 28 5.491781 LI
5 1 72 5 1 2 2098 327 122 27 5.491781 CANINE
5 1 72 5 1 3 2232 327 180 26 91.906952 DISTEMPER
3 1 72 6 0 0 2059 381 431 28 -1
4 1 72 6 1 0 2059 381 431 28 -1
5 1 72 6 1 1 2059 381 29 27 80.474670 LJ
5 1 72 6 1 2 2097 382 122 27 87.750458 CANINE
5 1 72 6 1 3 2230 382 260 26 92.115601 PARAINFLUENZA
3 1 72 7 0 0 2059 433 437 32 -1
4 1 72 7 1 0 2059 433 437 32 -1
5 1 72 7 1 1 2059 436 158 29 0.000000 LICANINE
5 1 72 7 1 2 2226 438 209 26 95.577545 ADENOVIRUS
5 1 72 7 1 3 2446 439 16 25 86.277176 2
5 1 72 7 1 4 2491 433 5 15 0.000000 '
3 1 72 8 0 0 2058 490 371 31 -1
4 1 72 8 1 0 2058 490 371 31 -1
5 1 72 8 1 1 2058 490 29 29 58.109550 LI
5 1 72 8 1 2 2095 493 122 28 65.164268 CANINE
5 1 72 8 1 3 2227 493 202 26 96.183868 PARVOVIRUS
3 1 72 9 0 0 2056 547 404 29 -1
4 1 72 9 1 0 2056 547 404 29 -1
5 1 72 9 1 1 2056 547 29 28 1.151152 LI
5 1 72 9 1 2 2094 550 122 26 1.151152 CANINE
5 1 72 9 1 3 2226 549 234 26 95.832420 CORONAVIRUS
3 1 72 10 0 0 2055 603 380 29 -1
4 1 72 10 1 0 2055 603 380 29 -1
5 1 72 10 1 1 2055 603 29 27 53.175209 LI
5 1 72 10 1 2 2092 606 122 26 53.175209 CANINE
5 1 72 10 1 3 2226 604 209 26 95.977058 BORDETELLA
3 1 72 11 0 0 2053 658 290 28 -1
4 1 72 11 1 0 2053 658 290 28 -1
5 1 72 11 1 1 2053 658 31 28 0.000000 (CI
5 1 72 11 1 2 2092 660 251 26 0.000000 LEPTOSPIROSIS
3 1 72 12 0 0 2052 714 425 35 -1
4 1 72 12 1 0 2052 714 425 35 -1
5 1 72 12 1 1 2052 714 30 27 68.285652 (7
5 1 72 12 1 2 2091 715 110 26 96.435471 FELINE
5 1 72 12 1 3 2212 715 160 34 94.767944 LEUKEMIA
5 1 72 12 1 4 2380 715 97 26 96.361610 VIRUS
3 1 72 13 0 0 2052 769 425 28 -1
4 1 72 13 1 0 2052 769 425 28 -1
5 1 72 13 1 1 2052 769 147 28 41.416126 [FELINE
5 1 72 13 1 2 2211 771 266 26 90.439690 PANLEUKOPENIA
3 1 72 14 0 0 2050 823 448 29 -1
4 1 72 14 1 0 2050 823 448 29 -1
5 1 72 14 1 1 2050 823 149 29 53.315163 OOFELINE
5 1 72 14 1 2 2209 826 289 26 81.557137 RHINOTRACHEITIS
3 1 72 15 0 0 2049 879 357 29 -1
4 1 72 15 1 0 2049 879 357 29 -1
5 1 72 15 1 1 2049 879 29 29 59.855873 C]
5 1 72 15 1 2 2088 882 110 26 93.273720 FELINE
5 1 72 15 1 3 2208 882 198 26 91.498909 CALICIVIRUS
3 1 72 16 0 0 2047 934 347 29 -1
4 1 72 16 1 0 2047 934 347 29 -1
5 1 72 16 1 1 2047 934 31 29 71.351028 CJ
5 1 72 16 1 2 2086 937 110 26 83.446098 FELINE
5 1 72 16 1 3 2206 937 188 26 96.133270 CHLAMYDIA
3 1 72 17 0 0 2046 990 453 77 -1
4 1 72 17 1 0 2046 990 453 29 -1
5 1 72 17 1 1 2046 990 149 29 72.448044 OOFELINE
5 1 72 17 1 2 2206 993 293 26 54.183647 iMMUNODEFICIEN(
4 1 72 17 2 0 2084 1041 97 26 -1
5 1 72 17 2 1 2084 1041 97 26 95.462311 VIRUS
2 1 73 0 0 0 2103 1162 36 58 -1
3 1 73 1 0 0 2103 1162 36 58 -1
4 1 73 1 1 0 2103 1162 36 58 -1
5 1 73 1 1 1 2103 1148 36 72 89.668854 th
2 1 74 0 0 0 2175 1141 180 82 -1
3 1 74 1 0 0 2175 1141 180 82 -1
4 1 74 1 1 0 2175 1141 180 40 -1
5 1 74 1 1 1 2175 1134 180 47 96.883705 Boehringer
4 1 74 1 2 0 2175 1183 164 40 -1
5 1 74 1 2 1 2175 1183 164 40 55.871159 lngelheim
2 1 75 0 0 0 2008 1603 485 958 -1
3 1 75 1 0 0 2024 1603 360 26 -1
4 1 75 1 1 0 2024 1603 360 26 -1
5 1 75 1 1 1 2024 1603 214 26 96.139824 VACCINATION
5 1 75 1 1 2 2250 1603 134 26 93.901871 RECORD
3 1 75 2 0 0 2025 1653 86 24 -1
4 1 75 2 1 0 2025 1653 86 24 -1
5 1 75 2 1 1 2025 1653 86 24 96.503204 Name
3 1 75 3 0 0 2020 1706 155 28 -1
4 1 75 3 1 0 2020 1706 155 28 -1
5 1 75 3 1 1 2020 1706 31 28 33.271149 CI
5 1 75 3 1 2 2061 1708 114 26 33.271149 RABIES
3 1 75 4 0 0 2020 1761 268 29 -1
4 1 75 4 1 0 2020 1761 268 29 -1
5 1 75 4 1 1 2020 1761 122 29 0.000000 [FILYME
5 1 75 4 1 2 2154 1764 134 26 96.044594 DISEASE
3 1 75 5 0 0 2019 1816 353 31 -1
4 1 75 5 1 0 2019 1816 353 31 -1
5 1 75 5 1 1 2019 1816 30 29 51.675308 (3
5 1 75 5 1 2 2058 1819 120 26 34.311501 CANINE
5 1 75 5 1 3 2190 1819 182 28 90.433800 DISTEMPER
3 1 75 6 0 0 2017 1872 434 29 -1
4 1 75 6 1 0 2017 1872 434 29 -1
5 1 75 6 1 1 2017 1872 31 29 81.338951 CJ
5 1 75 6 1 2 2057 1875 120 26 93.294052 CANINE
5 1 75 6 1 3 2190 1875 261 26 92.754234 PARAINFLUENZA
3 1 75 7 0 0 2017 1927 404 29 -1
4 1 75 7 1 0 2017 1927 404 29 -1
5 1 75 7 1 1 2017 1927 31 29 50.601761 CO
5 1 75 7 1 2 2056 1930 121 26 50.601761 CANINE
5 1 75 7 1 3 2185 1930 209 26 95.148758 ADENOVIRUS
5 1 75 7 1 4 2406 1931 15 25 96.498795 2
3 1 75 8 0 0 2016 1983 389 29 -1
4 1 75 8 1 0 2016 1983 389 29 -1
5 1 75 8 1 1 2016 1983 30 29 59.581432 C)
5 1 75 8 1 2 2055 1986 120 26 96.142021 CANINE
5 1 75 8 1 3 2187 1986 200 26 93.285515 PARVOVIRUS
5 1 75 8 1 4 2403 1997 2 3 85.456749 -
3 1 75 9 0 0 2015 2038 405 29 -1
4 1 75 9 1 0 2015 2038 405 29 -1
5 1 75 9 1 1 2015 2038 30 29 53.176544 [J
5 1 75 9 1 2 2055 2041 120 26 94.552086 CANINE
5 1 75 9 1 3 2185 2041 235 26 95.940544 CORONAVIRUS
3 1 75 10 0 0 2014 2094 380 30 -1
4 1 75 10 1 0 2014 2094 380 30 -1
5 1 75 10 1 1 2014 2094 31 29 58.851082 CO
5 1 75 10 1 2 2053 2097 121 27 58.851082 CANINE
5 1 75 10 1 3 2185 2097 209 26 96.527206 BORDETELLA
3 1 75 11 0 0 2013 2150 293 30 -1
4 1 75 11 1 0 2013 2150 293 30 -1
5 1 75 11 1 1 2013 2150 30 28 85.142654 {J
5 1 75 11 1 2 2053 2154 253 26 87.364578 LEPTOSPIROSIS
3 1 75 12 0 0 2013 2206 425 31 -1
4 1 75 12 1 0 2013 2206 425 31 -1
5 1 75 12 1 1 2013 2206 30 28 49.949879 (J
5 1 75 12 1 2 2052 2209 108 26 93.328758 FELINE
5 1 75 12 1 3 2173 2209 160 28 94.799042 LEUKEMIA
5 1 75 12 1 4 2341 2208 97 26 95.233063 VIRUS
3 1 75 13 0 0 2011 2262 427 29 -1
4 1 75 13 1 0 2011 2262 427 29 -1
5 1 75 13 1 1 2011 2262 31 29 66.649429 C)
5 1 75 13 1 2 2052 2265 108 26 92.823509 FELINE
5 1 75 13 1 3 2172 2263 266 26 90.556908 PANLEUKOPENIA
3 1 75 14 0 0 2011 2317 449 29 -1
4 1 75 14 1 0 2011 2317 449 29 -1
5 1 75 14 1 1 2011 2317 31 28 32.586075 (CO
5 1 75 14 1 2 2050 2320 110 26 91.329292 FELINE
5 1 75 14 1 3 2170 2319 290 26 91.935341 RHINOTRACHEITIS
3 1 75 15 0 0 2011 2373 356 29 -1
4 1 75 15 1 0 2011 2373 356 29 -1
5 1 75 15 1 1 2011 2373 29 29 70.749443 LJ
5 1 75 15 1 2 2050 2376 109 26 70.749443 FELINE
5 1 75 15 1 3 2169 2374 198 26 84.548790 CALICIVIRUS
3 1 75 16 0 0 2010 2428 347 29 -1
4 1 75 16 1 0 2010 2428 347 29 -1
5 1 75 16 1 1 2010 2428 29 29 84.100731 (1
5 1 75 16 1 2 2049 2430 108 26 92.243195 FELINE
5 1 75 16 1 3 2168 2430 189 27 95.689308 CHLAMYDIA
3 1 75 17 0 0 2008 2484 485 77 -1
4 1 75 17 1 0 2008 2484 485 29 -1
5 1 75 17 1 1 2008 2484 31 29 0.000000 (9)
5 1 75 17 1 2 2049 2487 108 26 93.342949 FELINE
5 1 75 17 1 3 2168 2485 325 26 63.923489 IMMUNODEFICIENCY
4 1 75 17 2 0 2047 2535 97 26 -1
5 1 75 17 2 1 2047 2535 97 26 95.508324 VIRUS
2 1 76 0 0 0 2119 1670 332 19 -1
3 1 76 1 0 0 2119 1670 332 19 -1
4 1 76 1 1 0 2119 1670 332 19 -1
5 1 76 1 1 1 2119 1670 332 19 95.000000
2 1 77 0 0 0 2067 2634 254 81 -1
3 1 77 1 0 0 2074 2634 247 81 -1
4 1 77 1 1 0 2138 2634 183 39 -1
5 1 77 1 1 1 2138 2634 183 39 95.723923 Boehringer
4 1 77 1 2 0 2067 2641 236 74 -1
5 1 77 1 2 1 2067 2641 35 71 57.668343 i
5 1 77 1 2 2 2138 2676 165 39 96.490028 Ingelheim
2 1 78 0 0 0 2544 162 6 73 -1
3 1 78 1 0 0 2544 162 6 73 -1
4 1 78 1 1 0 2544 162 6 73 -1
5 1 78 1 1 1 2544 162 6 73 95.000000
2 1 79 0 0 0 2491 426 59 2859 -1
3 1 79 1 0 0 2491 426 59 2859 -1
4 1 79 1 1 0 2491 426 59 2859 -1
5 1 79 1 1 1 2491 426 59 2859 95.000000
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VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $: Name
ADAPTED NASPHV FORM 57 Tag #
CIRABIES
Cert. Serial - #:
Owner’s Name & Address PRINT - use ball point pen or type
(COLYME DISEASE
PRINT LAST wEIRST, ee Mi TELEPHONE par, ay CICANINE DISTEMPER
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NO. STREET CITY . STATE ZIRE
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Dog Male 3 Mo. to 12 Mo. 1 | Under 20 Ibs. Chakvalve SO CICANINE CORONAVIRUS
:
cat OO Femate [| 12 Mo. orolder G3 20 - 50 Ibs 0 CICANINE BORDETELLA
Other O Altered Ch Over 50 Ibs. [1]; NAME: CULEPTOSPIROSIS
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PRODUCER: i { it.
DATE VACCINATED: i — Veterinarian’s #
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Month Day Year
Vacc. Serial Lo (Lot) No. , Ee Lon * 7 ~\ Boehringer
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VAC0410001
VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $:
Name
ADAPTED NASPHV FORM 57 Tag #:
(7) RABIES
Owner's Name & Address PRINT - use ball point pen or type Cert, Serial #:
LILYME DISEASE
L-PRINT LAST EIBST beg Mi TELEPHONE, cast ’ (1 CANINE DISTEMPER
Suaendacs IES PB3-Sete
3 1 66 4 0 0 204 1944 1388 30 -1
4 1 66 4 1 0 204 1944 1388 30 -1
5 1 66 4 1 1 204 1947 48 23 93.302307 NO.
5 1 66 4 1 2 394 1946 107 24 95.639221 STREET
5 1 66 4 1 3 657 1963 15 8 36.616970 bs
5 1 66 4 1 4 939 1945 62 23 7.488194 CY
5 1 66 4 1 5 1057 1947 122 27 19.467878 AA
5 1 66 4 1 6 1314 1944 83 24 96.308464 STATE
5 1 66 4 1 7 1540 1945 52 23 63.058605 “ZIP,
3 1 66 5 0 0 199 1948 1550 134 -1
4 1 66 5 1 0 213 1965 1526 32 -1
5 1 66 5 1 1 213 1979 18 13 2.032852 “3
5 1 66 5 1 2 264 1982 4 6 43.155663 ote
5 1 66 5 1 3 399 1980 18 11 45.977982 =,
5 1 66 5 1 4 469 1978 26 8 29.381329 xa
5 1 66 5 1 5 540 1972 18 5 55.912704 it
5 1 66 5 1 6 588 1975 18 10 27.011456 oh
5 1 66 5 1 7 697 1983 16 6 10.923405 7
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Dog EF Male [1|'8 Mo. to 12 Mo. LC] Under 20 Ibs. [41 “Ea. i" (1 CANINE CORONAVIRUS
“Verre
cat O Female | 12 Mo, or older 20-50ibs C) GANINE BORDETELLA
Other 0 Altered Over 50 tbs. [2] NAME:
COLEPTOSPIROSIS
“Puc
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(Specify) C) FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: cf By t ge Sts ( FELINE PANLEUKOPENIA
ms -—- “os Veterinarian’s #
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Month Day Year
; Vacc. Serial too (Lot) No. fet ~ *9O0e7 #
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ih Ingelheim
VACG410001
VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Jag fee $: Name
ADAPTED NASPHV FORM 57 Tag #: CORABIES
Cert. Serial #:
Owner's Name & Address PAINT - use ball point pen or type CILYME DISEASE
PRINT LA AST wet MI TELEPHONE ce Gl COCANINE DISTEMPER
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SPECIES: AGE: SIZE: BREED: | COLORS:
Dog DR | Male DA] 3 Mo. to 12 Mo. [1] Under 20 tbs. BE) Ch, cf ~ ae . ; CICANINE CORONAVIRUS
cat O Female [1] 12Mo.orolder §2]20-50bs 0 nUaANY A COUGANINE BORDETELLA
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Month Day Year (First 3 Letters) | Veterinarian
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3 5 < § Ky 4H1S.4 7
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Month Day Year
Vacc. Serial (Lot} No. Boehringer
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VAC0410001
VACCINATION RECORD
RABIES VACCINATION GERTIFICATE Tag fee $:
Name
ADAPTED NASPHV FORM 57 Tag i:
CORABIES
Owner's Name & Address PRINT - use bal! point pen or type Gert. Serial #:
[) LYME DISEASE
. Mt a |DELEPHONE ps oo Py (] CANINE DISTEMPER
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AGE: SIZE: Calon CICANINE PARVOVIRUS
SPECIES: | PREDOMINANT BREED:
Dog “fl Male SE] 3 Mo. to 12 Mo. [1} Under 20 tos. JX] i) eC? (1) CANINE CORONAVIRUS
ancy ay aK DUIS URC.
cat UO Female ial 12 Mo. or older Be 20 - 50 Ibs (A CANINE
BORDETELLA
Other Altered Over 50 tbs. (| NAME:
LILEPTOSPIROSIS
(Specify) NROVO C1 FELINE LEUKEMIA VIRUS
a PRODUCER: Votorman ale Th il pb CJ FELINE PANLEUKOPENIA
Daye /
FN ae de ( RAK} Py e eee icense No." CO FELINE RHINOTRACHEITIS
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Nonih Day LD FELINE CALICIVIRUS
Year (First 3 Letters)
C1 FELINE CHLAMYDIA
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VAGGINATIQN EXPIRES: ] FELINE IMMUNODEFICIENCY
4 <9 *7]_| 3 yr Lic.Wace. Address,”
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Month Day Year oH iA. \ 5 = ze
(Lot) No.
Boehringer
Ingelheim
VAC0470004
-
RABIES VACCINATION CERTIFICATE Tag fee $:
ADAPTED NASPHV FORM 57 Tag #:
Owner's Name & Address PRINT - use ball paint pen or type Cert. Serial #:
PRINT LA EIRST et MI FELRPHONE “ah (W?
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SPECIES: SEX: AGE: SIZE: PREDOMINANT BREED; | COLORS:
|
Dog Male [ef] 3 Mo. to 12 Mo. CI| Under 20 Ibs. OPP) fp pes “Tre
| ' ai u 4
cat OF Female (| 12 Mo. orolder fa] 20-50lbs
Other 2 Altered oy Over 50 Ibs, [7] | NAME:
(Specify) C 4 Aa ucthlce
DATE VACCINATED: PRODUCER: eee UW
Veterinarian's¢
> VO { (y R QD 3 License No.
Month Day Year r fae
(First Fi 3 3 Lett Letters) Veterinarian’s
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EXPIRES: ventroyh Signature
VACCINATION —
3 yr. Lic. Vace.
Month Day Year . -—__ retco 3 } Ss
Vacc. Serial {Lot) No.
VACO410001
RABIES VACCINATION CERTIFICATE Tag fee $:
ADAPTED NASPHV FORM 57 Tag i:
Cert. Serial #:
Owner's Name & Address PRINT - use ball point pen or type
BRINT LAST, FIRST. oo. ve MI ra E LERHON at wy Pe
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Ces Ee YOIST
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SPEGIES:, Po SEX: “AGE: SIZE: PREDOMINANT BREED: COLORS:
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Dog Male 8 Mo. to 12 Mo. (1 |.Under 20 Ibs. BI} 44" Pascua j
ca OO Female (1 {42 Mo. or older 20-50ibs [)
Other Altered Over 50 tbs. (]{ NAME:
(Specify) Lagovesy
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DATE VACCINATED: PRODUCER: Veterinarians ret { gL
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Month = Day Year First 3 Letters) ei
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VACCINATION EXPIRES: | Oo Hey ee
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Month Day Year “
Vacc. Serial j (Lot} No. - : CL) AS =
J a 4 =) ; S 5 1 65 1 24 13 1932 2901 3 6 8.249340 .
4 1 65 1 25 0 1932 2909 3 24 -1
5 1 65 1 25 1 1932 2909 3 24 77.481216 i
2 1 66 0 0 0 1904 1827 28 1094 -1
3 1 66 1 0 0 1904 1827 28 1094 -1
4 1 66 1 1 0 1904 1827 28 1094 -1
5 1 66 1 1 1 1904 1827 28 1094 95.000000
2 1 67 0 0 0 178 2891 1736 62 -1
3 1 67 1 0 0 178 2891 1736 62 -1
4 1 67 1 1 0 178 2891 1736 62 -1
5 1 67 1 1 1 178 2891 1736 62 95.000000
2 1 68 0 0 0 178 2943 164 23 -1
3 1 68 1 0 0 178 2943 164 23 -1
4 1 68 1 1 0 178 2943 164 23 -1
5 1 68 1 1 1 178 2943 164 23 63.314129 VAC0410001
2 1 69 0 0 0 2035 49 466 1012 -1
3 1 69 1 0 0 2035 49 466 964 -1
4 1 69 1 1 0 2364 49 137 39 -1
5 1 69 1 1 1 2364 49 137 39 0.000000 oS
4 1 69 1 2 0 2052 105 363 27 -1
5 1 69 1 2 1 2052 105 216 27 96.412132 VACCINATION
5 1 69 1 2 2 2280 105 135 26 61.956734 RECORD
4 1 69 1 3 0 2053 153 86 27 -1
5 1 69 1 3 1 2053 153 86 27 96.432655 Name
4 1 69 1 4 0 2049 207 156 30 -1
5 1 69 1 4 1 2049 207 30 29 49.703766 CJ
5 1 69 1 4 2 2088 211 117 26 49.703766 RABIES
4 1 69 1 5 0 2049 262 267 32 -1
5 1 69 1 5 1 2049 262 29 29 12.731047 (1
5 1 69 1 5 2 2088 265 84 28 12.731047 LYME
5 1 69 1 5 3 2184 267 132 27 96.250290 DISEASE
4 1 69 1 6 0 2047 318 353 30 -1
5 1 69 1 6 1 2047 318 161 30 23.203249 LCOCANINE
5 1 69 1 6 2 2220 321 180 27 92.423279 DISTEMPER
4 1 69 1 7 0 2046 373 434 31 -1
5 1 69 1 7 1 2046 373 162 31 75.810852 CIGANINE
5 1 69 1 7 2 2218 376 262 28 90.681404 PARAINFLUENZA
4 1 69 1 8 0 2046 429 405 30 -1
5 1 69 1 8 1 2046 429 29 27 61.229130 LI
5 1 69 1 8 2 2084 432 123 27 72.175179 CANINE
5 1 69 1 8 3 2215 432 209 27 95.345337 ADENOVIRUS
5 1 69 1 8 4 2434 433 17 25 96.073753 2
4 1 69 1 9 0 2044 484 374 31 -1
5 1 69 1 9 1 2044 484 31 28 51.310928 (4
5 1 69 1 9 2 2083 487 122 26 91.714745 CANINE
5 1 69 1 9 3 2217 487 201 28 96.189644 PARVOVIRUS
4 1 69 1 10 0 2043 540 405 29 -1
5 1 69 1 10 1 2043 540 30 27 44.002338 DI
5 1 69 1 10 2 2082 543 123 26 44.002338 CANINE
5 1 69 1 10 3 2215 543 233 26 95.254845 CORONAVIRUS
4 1 69 1 11 0 2043 595 381 29 -1
5 1 69 1 11 1 2043 595 30 28 44.433670 LI
5 1 69 1 11 2 2080 597 124 27 44.433670 CANINE
5 1 69 1 11 3 2215 598 209 26 96.461189 BORDETELLA
4 1 69 1 12 0 2041 651 293 29 -1
5 1 69 1 12 1 2041 651 31 27 11.352472 CI
5 1 69 1 12 2 2080 653 254 27 11.352472 LEPTOSPIROSIS
4 1 69 1 13 0 2041 705 425 30 -1
5 1 69 1 13 1 2041 705 29 29 37.408314 (0
5 1 69 1 13 2 2080 709 110 25 93.794853 FELINE
5 1 69 1 13 3 2202 709 159 26 95.881035 LEUKEMIA
5 1 69 1 13 4 2370 709 96 26 96.189217 VIRUS
4 1 69 1 14 0 2040 762 426 29 -1
5 1 69 1 14 1 2040 762 29 27 11.964865 CL]
5 1 69 1 14 2 2079 763 110 26 93.265739 FELINE
5 1 69 1 14 3 2200 765 266 26 90.351814 PANLEUKOPENIA
4 1 69 1 15 0 2038 816 449 30 -1
5 1 69 1 15 1 2038 816 31 29 19.075794 (J
5 1 69 1 15 2 2077 819 110 27 92.672920 FELINE
5 1 69 1 15 3 2199 820 288 26 86.320305 RHINOTRACHEITIS
4 1 69 1 16 0 2037 873 359 29 -1
5 1 69 1 16 1 2037 873 30 27 64.733719 CJ
5 1 69 1 16 2 2077 876 110 26 64.733719 FELINE
5 1 69 1 16 3 2197 876 199 26 90.633186 CALICIVIRUS
4 1 69 1 17 0 2036 927 349 30 -1
5 1 69 1 17 1 2036 927 150 30 16.409168 CFELINE
5 1 69 1 17 2 2197 931 188 26 96.565689 CHLAMYDIA
4 1 69 1 18 0 2035 984 461 29 -1
5 1 69 1 18 1 2035 984 31 27 42.860558 CO
5 1 69 1 18 2 2074 987 110 26 42.860558 FELINE
5 1 69 1 18 3 2197 987 299 26 90.241051 IMMUNODEFICIENC
3 1 69 2 0 0 2073 1035 98 26 -1
4 1 69 2 1 0 2073 1035 98 26 -1
5 1 69 2 1 1 2073 1035 98 26 96.172066 VIRUS
2 1 70 0 0 0 2148 174 332 15 -1
3 1 70 1 0 0 2148 174 332 15 -1
4 1 70 1 1 0 2148 174 332 15 -1
5 1 70 1 1 1 2148 174 332 15 95.000000
2 1 71 0 0 0 2085 1135 261 82 -1
3 1 71 1 0 0 2085 1135 261 82 -1
4 1 71 1 1 0 2099 1135 247 40 -1
5 1 71 1 1 1 2099 1141 24 14 17.467155 *\
5 1 71 1 1 2 2166 1135 180 40 95.156006 Boehringer
4 1 71 1 2 0 2085 1156 245 61 -1
5 1 71 1 2 1 2085 1156 44 58 43.673058 all
5 1 71 1 2 2 2165 1177 165 40 83.762871 ingelheim
2 1 72 0 0 0 2005 1827 479 959 -1
3 1 72 1 0 0 2014 1827 362 27 -1
4 1 72 1 1 0 2014 1827 362 27 -1
5 1 72 1 1 1 2014 1828 215 26 96.368248 VACCINATION
5 1 72 1 1 2 2242 1827 134 26 96.370575 RECORD
3 1 72 2 0 0 2016 1878 86 26 -1
4 1 72 2 1 0 2016 1878 86 26 -1
5 1 72 2 1 1 2016 1878 86 26 96.515045 Name
3 1 72 3 0 0 2011 1932 155 29 -1
4 1 72 3 1 0 2011 1932 155 29 -1
5 1 72 3 1 1 2011 1932 155 29 43.146194 CIRABIES
3 1 72 4 0 0 2011 1987 269 28 -1
4 1 72 4 1 0 2011 1987 269 28 -1
5 1 72 4 1 1 2011 1987 122 28 59.816887 CILYME
5 1 72 4 1 2 2145 1987 135 26 96.388351 DISEASE
3 1 72 5 0 0 2011 2037 353 33 -1
4 1 72 5 1 0 2011 2037 353 33 -1
5 1 72 5 1 1 2011 2041 29 29 76.068573 (CO
5 1 72 5 1 2 2049 2037 122 33 82.054955 CANINE
5 1 72 5 1 3 2182 2043 182 26 91.618866 DISTEMPER
3 1 72 6 0 0 2010 2097 434 29 -1
4 1 72 6 1 0 2010 2097 434 29 -1
5 1 72 6 1 1 2010 2097 30 29 56.051476 (2
5 1 72 6 1 2 2049 2099 122 27 84.524292 CANINE
5 1 72 6 1 3 2182 2098 262 26 91.279022 PARAINFLUENZA
3 1 72 7 0 0 2010 2152 407 29 -1
4 1 72 7 1 0 2010 2152 407 29 -1
5 1 72 7 1 1 2010 2152 29 29 0.000000 CO
5 1 72 7 1 2 2049 2155 120 26 0.000000 CANINE
5 1 72 7 1 3 2179 2154 209 26 95.989471 ADENOVIRUS
5 1 72 7 1 4 2400 2154 17 24 96.776764 2
3 1 72 8 0 0 2009 2208 373 29 -1
4 1 72 8 1 0 2009 2208 373 29 -1
5 1 72 8 1 1 2009 2208 160 29 0.000000 CDICANINE
5 1 72 8 1 2 2181 2209 201 26 96.091675 PARVOVIRUS
3 1 72 9 0 0 2008 2264 407 30 -1
4 1 72 9 1 0 2008 2264 407 30 -1
5 1 72 9 1 1 2008 2264 31 30 0.000000 CI
5 1 72 9 1 2 2047 2266 122 26 0.000000 CANINE
5 1 72 9 1 3 2179 2265 236 26 95.765114 CORONAVIRUS
3 1 72 10 0 0 2008 2320 382 29 -1
4 1 72 10 1 0 2008 2320 382 29 -1
5 1 72 10 1 1 2008 2320 160 29 13.206587 LICANINE
5 1 72 10 1 2 2179 2320 211 26 96.176544 BORDETELLA
3 1 72 11 0 0 2007 2359 293 46 -1
4 1 72 11 1 0 2007 2359 293 46 -1
5 1 72 11 1 1 2007 2359 293 46 30.418949 CULEPTOSPIROSIS
3 1 72 12 0 0 2007 2431 426 29 -1
4 1 72 12 1 0 2007 2431 426 29 -1
5 1 72 12 1 1 2007 2431 30 29 74.926414 (
5 1 72 12 1 2 2047 2433 107 27 95.995575 FELINE
5 1 72 12 1 3 2167 2432 161 27 95.756546 LEUKEMIA
5 1 72 12 1 4 2337 2431 96 26 96.468231 VIRUS
3 1 72 13 0 0 2007 2487 426 29 -1
4 1 72 13 1 0 2007 2487 426 29 -1
5 1 72 13 1 1 2007 2487 29 29 44.212097 CO
5 1 72 13 1 2 2046 2488 108 26 44.212097 FELINE
5 1 72 13 1 3 2166 2487 267 27 91.620232 PANLEUKOPENIA
3 1 72 14 0 0 2006 2542 450 29 -1
4 1 72 14 1 0 2006 2542 450 29 -1
5 1 72 14 1 1 2006 2542 148 29 67.636368 (FELINE
5 1 72 14 1 2 2166 2542 290 28 41.028801 RHINOTRACHENIS
3 1 72 15 0 0 2005 2598 358 29 -1
4 1 72 15 1 0 2005 2598 358 29 -1
5 1 72 15 1 1 2005 2598 149 29 29.057632 [FELINE
5 1 72 15 1 2 2164 2598 199 27 91.277451 CALICIVIRUS
3 1 72 16 0 0 2005 2653 349 29 -1
4 1 72 16 1 0 2005 2653 349 29 -1
5 1 72 16 1 1 2005 2653 29 29 52.666862 (1
5 1 72 16 1 2 2044 2655 109 26 85.764519 FELINE
5 1 72 16 1 3 2164 2653 190 28 79.710205 CHLAMYDIA
3 1 72 17 0 0 2005 2707 479 79 -1
4 1 72 17 1 0 2005 2707 479 31 -1
5 1 72 17 1 1 2005 2709 29 29 2.194777 CI
5 1 72 17 1 2 2044 2711 109 27 2.194777 FELINE
5 1 72 17 1 3 2164 2707 320 29 79.282242 iMMUNODEFICIENC)
4 1 72 17 2 0 2043 2760 96 26 -1
5 1 72 17 2 1 2043 2760 96 26 95.614929 VIRUS
2 1 73 0 0 0 2110 1897 332 13 -1
3 1 73 1 0 0 2110 1897 332 13 -1
4 1 73 1 1 0 2110 1897 332 13 -1
5 1 73 1 1 1 2110 1897 332 13 95.000000
2 1 74 0 0 0 2064 2858 254 82 -1
3 1 74 1 0 0 2064 2858 254 82 -1
4 1 74 1 1 0 2071 2858 247 39 -1
5 1 74 1 1 1 2071 2867 23 12 5.005474 *\
5 1 74 1 1 2 2135 2858 183 39 94.339333 Boehringer
4 1 74 1 2 0 2064 2882 236 58 -1
5 1 74 1 2 1 2064 2882 36 55 59.772869 il
5 1 74 1 2 2 2135 2900 165 40 63.544334 Ingelheim
2 1 75 0 0 0 2497 3 53 3282 -1
3 1 75 1 0 0 2497 3 53 3282 -1
4 1 75 1 1 0 2497 3 53 3282 -1
5 1 75 1 1 1 2497 3 53 3282 95.000000
VACCINATION RECORD
, RABIES VACCINATION CERTIFICATE Tag fee $:
Name
“ADAPTED NASPHV FORM 57 Tag #
CO RABIES
Owner’s Name & Address PRINT ~ use ball point pen or type Cart. Serial #:
COLYME DISEASE
-PRINT LAST RIRST, woe oe Mi TELEPHONE . CCANINE DISTEMPER
OH
Pree, Phishine 60283
(J CANINE PARAINFLUENZA
O. | STREET on a STATE © EPIC
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CI CANINE PARVOVIRUS
SPECIES; SEX: AGE: SIZE: PREDOMINANT BREED: | COLORS:
.
Dog oy ‘Male (|,3 Mo. to 12 Mo. Ci |_Under 20 Ibs. ag | OW (I CANINE CORONAVIRUS
COCA Ow
ca O Female fy 12 Mo. or older F120 - 50 bs OL™ CI CANINE BORDETELLA
_
Other Altered f& Over 50 Ibs. [J | NAME: |
CULEPTOSPIROSIS
(Specify) Chihuahua
( FELINE LEUKEMIA VIRUS
t ei (0 FELINE PANLEUKOPENIA
PRODUCER:
DATE VACGINATED: Veterinarian #
7 | she fa) ia icense ' CI FELINE RHINOTRACHEITIS
2, oO 1G R OL
CI FELINE CALICIVIRUS
“enn id “ ist $ Letters) Se
, Veterinarian's”~ (FELINE CHLAMYDIA
1 yz. Lic. Wace. [8 i
VACCINATION ExpIRES: Signature F—}—_> (1 FELINE {MMUNODEFICIENC)
a) ey, PSP] Syn UicMace.O ¢%j B04 le Address n.. VIRUS
Month Day Year -
Vace. acc, Serial Serial ( 7 of (Lot) No. jo yf Plea = & FF “a
wi etco avy S Boehringer
ii
Ingelheim
VACC410001
VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $:
. Name
ADAPTED NASPHV FORM 57 ‘Tag #:
(2) RABIES
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial #:
0
Wig SEAS
ORV LAST ed. 7 CYA rbd Mi TELEPHO) hey }
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AGE: 6b
2 : Male SIZE: ry Pj Pe MIR we B ne JOLORS: CL] CANINE PARVOVIRUS
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Dog \Yé) Cl 3 Mo. to 12 Mo. C]j Under 20 Ibs. Pr pees Lim LI GANINE
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cat OO Female “E42 Mo. or older D&)|20-50bs 1 or —F
Li CANINE BORDETELLA
Other O Altered 7. Over 50 tbs. O
(J LEPTOSPIROSIS
(Specify) IV
‘er OJ) FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER:. UGER (con (J FELINE PANLEUKOPENIA
3 3 Veterinarian’s #
ay Be a i ATS ) LicepfSa oa Nov C) FELINE RHINOTRAGCHEITIS
5 CL
Month Day Year ~ ~ () FELINE CALICIVIRUS
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1 ye yr. Li UeWace. Bk, Signatur
VACCINATION (FELINE (MMUNODEFICIENCY
my WO oe . 3 yr. Lic.WVace, /
[=i a EG Hy gn Lh Address . VIRUS
Month Day ar — oe BE
Vacc. Seriaf (Lot) No. ad neal
Boehringer
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VAC0410001 Ingelheim
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STATE 74 | .
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SPECIES: AGE: SIZE: PREDOMINANT BREEO: ORS:
Dog ue Male [| 3 Mo. to 12 Mo. LJj Under 20 Ibs. [55 ae Ste sl “
at ,. ee OWS,
cat O Female [ay 42 Mo. orolder &b{20-50lbs | i
Othe O Altered Over 50 Ibs. O NAME:
;
(Specify) Sher Aas he
DATE VACCINATED: PRODUCER:. G 4 UE
- Veterinarian's #
By
5 1 31 1 14 2 361 819 77 42 39.592457 23
5 1 31 1 14 3 489 814 11 47 0.000000 [
5 1 31 1 14 4 498 822 35 42 24.124031 6
5 1 31 1 14 5 725 822 3 3 0.000000 ;
5 1 31 1 14 6 837 801 44 65 19.373074 R,
5 1 31 1 14 7 890 809 39 49 46.706841 oS
5 1 31 1 14 8 958 801 38 59 24.530106 iS
5 1 31 1 14 9 1192 817 4 4 0.000000 .
5 1 31 1 14 10 1423 817 100 23 96.865021 License
5 1 31 1 14 11 1533 817 44 23 87.072433 No.
4 1 31 1 15 0 223 874 319 29 -1
5 1 31 1 15 1 223 874 80 23 96.361130 Month
5 1 31 1 15 2 372 876 48 27 96.590866 Day
5 1 31 1 15 3 484 876 58 23 96.951126 Year
2 1 32 0 0 0 1349 981 556 14 -1
3 1 32 1 0 0 1349 981 556 14 -1
4 1 32 1 1 0 1349 981 556 14 -1
5 1 32 1 1 1 1349 981 556 14 95.000000
2 1 33 0 0 0 1332 1040 570 16 -1
3 1 33 1 0 0 1332 1040 570 16 -1
4 1 33 1 1 0 1332 1040 570 16 -1
5 1 33 1 1 1 1332 1040 570 16 95.000000
2 1 34 0 0 0 1329 1102 569 14 -1
3 1 34 1 0 0 1329 1102 569 14 -1
4 1 34 1 1 0 1329 1102 569 14 -1
5 1 34 1 1 1 1329 1102 569 14 95.000000
2 1 35 0 0 0 1200 471 16 714 -1
3 1 35 1 0 0 1200 471 16 714 -1
4 1 35 1 1 0 1200 471 16 714 -1
5 1 35 1 1 1 1200 471 16 714 95.000000
2 1 36 0 0 0 1924 94 25 1091 -1
3 1 36 1 0 0 1924 94 25 1091 -1
4 1 36 1 1 0 1924 94 25 1091 -1
5 1 36 1 1 1 1924 94 25 1091 95.000000
2 1 37 0 0 0 189 1163 1739 40 -1
3 1 37 1 0 0 189 1163 1739 40 -1
4 1 37 1 1 0 189 1163 1739 40 -1
5 1 37 1 1 1 189 1163 1739 40 95.000000
2 1 38 0 0 0 193 1654 1736 41 -1
3 1 38 1 0 0 193 1654 1736 41 -1
4 1 38 1 1 0 193 1654 1736 41 -1
5 1 38 1 1 1 193 1654 1736 41 95.000000
2 1 39 0 0 0 190 1833 1736 42 -1
3 1 39 1 0 0 190 1833 1736 42 -1
4 1 39 1 1 0 190 1833 1736 42 -1
5 1 39 1 1 1 190 1833 1736 42 95.000000
2 1 40 0 0 0 189 1020 1553 903 -1
3 1 40 1 0 0 231 1020 1094 72 -1
4 1 40 1 1 0 231 1020 1094 72 -1
5 1 40 1 1 1 231 1021 56 47 52.515602 <<
5 1 40 1 1 2 354 1026 80 38 64.636330 Bs
5 1 40 1 1 3 475 1029 29 38 0.000000 *
5 1 40 1 1 4 519 1022 8 49 58.300201 |
5 1 40 1 1 5 924 1047 33 24 50.829933 ad
5 1 40 1 1 6 949 1038 37 54 54.211918 “il
5 1 40 1 1 7 1069 1044 29 20 24.703941 1
5 1 40 1 1 8 1214 1020 111 27 93.924950 ‘Address
3 1 40 2 0 0 211 1030 880 84 -1
4 1 40 2 1 0 211 1030 880 84 -1
5 1 40 2 1 1 211 1076 80 38 96.077293 Month
5 1 40 2 1 2 368 1081 49 29 96.728729 Day
5 1 40 2 1 3 480 1081 59 23 96.990585 Year
5 1 40 2 1 4 816 1044 155 57 0.000000 Ecol
5 1 40 2 1 5 970 1038 16 50 0.000000 l
5 1 40 2 1 6 990 1042 23 44 34.402718 &
5 1 40 2 1 7 1068 1030 23 62 22.875973 ‘|
3 1 40 3 0 0 813 1090 929 85 -1
4 1 40 3 1 0 813 1090 929 85 -1
5 1 40 3 1 1 813 1090 69 47 66.821396 Vace.
5 1 40 3 1 2 892 1114 73 23 6.734533 Serial
5 1 40 3 1 3 973 1114 56 29 89.719734 (Lot}
5 1 40 3 1 4 1039 1114 43 23 96.684883 No.
5 1 40 3 1 5 1390 1119 37 56 27.832346 V
5 1 40 3 1 6 1419 1104 18 46 66.459900 fi
5 1 40 3 1 7 1446 1126 29 41 58.466354 €
5 1 40 3 1 8 1498 1119 32 48 0.000000 -
5 1 40 3 1 9 1533 1117 35 44 0.000000 ‘<
5 1 40 3 1 10 1567 1122 29 38 58.007004 C
5 1 40 3 1 11 1627 1117 115 56 27.371277 ays
3 1 40 4 0 0 189 1191 1538 705 -1
4 1 40 4 1 0 189 1191 1358 45 -1
5 1 40 4 1 1 189 1197 167 23 54.138641 VAC0410007
5 1 40 4 1 2 1284 1224 8 8 42.014038 .
5 1 40 4 1 3 1377 1215 15 21 21.473392 .
5 1 40 4 1 4 1517 1191 30 15 25.137148 ie
4 1 40 4 2 0 1146 1261 380 47 -1
5 1 40 4 2 1 1146 1299 27 8 79.263138 ne
5 1 40 4 2 2 1181 1267 92 41 3.959322 certs
5 1 40 4 2 3 1277 1280 64 27 0.000000 hc,
5 1 40 4 2 4 1361 1296 18 9 36.961098 te
5 1 40 4 2 5 1390 1261 31 46 0.000000 &
5 1 40 4 2 6 1438 1299 13 6 52.675976 a
5 1 40 4 2 7 1470 1287 56 18 51.914001 Ate
4 1 40 4 3 0 687 1697 990 40 -1
5 1 40 4 3 1 687 1702 150 32 93.296379 RABIES
5 1 40 4 3 2 849 1702 282 32 89.274223 VACGINATION
5 1 40 4 3 3 1146 1697 264 39 95.673645 CERTIFICATE
5 1 40 4 3 4 1552 1710 47 27 96.667168 Tag
5 1 40 4 3 5 1606 1710 40 21 93.216324 fee
5 1 40 4 3 6 1655 1707 22 27 92.831810 $:
4 1 40 4 4 0 795 1756 834 32 -1
5 1 40 4 4 1 795 1759 173 29 91.494606 ADAPTED
5 1 40 4 4 2 978 1759 153 29 86.055061 NASPHV
5 1 40 4 4 3 1138 1759 109 29 96.654549 FORM
5 1 40 4 4 4 1257 1761 38 27 90.206612 57
5 1 40 4 4 5 1552 1756 46 28 92.316055 Tag
5 1 40 4 4 6 1606 1756 23 22 90.895142 #:
4 1 40 4 5 0 208 1800 1519 39 -1
5 1 40 4 5 1 208 1815 107 24 96.454453 Owner's
5 1 40 4 5 2 324 1816 75 23 91.785179 Name
5 1 40 4 5 3 408 1818 18 21 91.785179 &
5 1 40 4 5 4 432 1816 108 23 96.498566 Address
5 1 40 4 5 5 849 1810 74 20 93.049049 PRINT
5 1 40 4 5 6 931 1820 8 4 89.929527 -
5 1 40 4 5 7 948 1815 41 15 94.391579 use
5 1 40 4 5 8 996 1810 42 19 94.391579 ball
5 1 40 4 5 9 1045 1810 61 23 89.118202 pain?
5 1 40 4 5 10 1113 1815 42 18 96.322266 pen
5 1 40 4 5 11 1165 1815 25 15 95.966499 or
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3 1 42 1 0 0 188 1934 1688 39 -1
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3 1 43 1 0 0 207 1932 128 120 -1
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3 1 44 1 0 0 333 1896 380 195 -1
4 1 44 1 1 0 333 1896 380 195 -1
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3 1 47 1 0 0 187 2031 1737 42 -1
4 1 47 1 1 0 187 2031 1737 42 -1
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3 1 48 1 0 0 403 2052 6 204 -1
4 1 48 1 1 0 403 2052 6 204 -1
5 1 48 1 1 1 403 2052 6 204 95.000000
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3 1 49 1 0 0 940 2052 6 204 -1
4 1 49 1 1 0 940 2052 6 204 -1
5 1 49 1 1 1 940 2052 6 204 95.000000
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3 1 50 1 0 0 623 2050 7 206 -1
4 1 50 1 1 0 623 2050 7 206 -1
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3 1 51 1 0 0 1544 2157 351 12 -1
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3 1 52 1 0 0 1192 2180 338 9 -1
4 1 52 1 1 0 1192 2180 338 9 -1
5 1 52 1 1 1 1192 2180 338 9 95.000000
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3 1 53 1 0 0 402 2244 792 21 -1
4 1 53 1 1 0 402 2244 792 21 -1
5 1 53 1 1 1 402 2244 792 21 95.000000
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3 1 54 1 0 0 1542 2267 351 11 -1
4 1 54 1 1 0 1542 2267 351 11 -1
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3 1 55 1 0 0 1525 1920 10 413 -1
4 1 55 1 1 0 1525 1920 10 413 -1
5 1 55 1 1 1 1525 1920 10 413 95.000000
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3 1 56 1 0 0 183 2309 1738 41 -1
4 1 56 1 1 0 183 2309 1738 41 -1
5 1 56 1 1 1 183 2309 1738 41 95.000000
2 1 57 0 0 0 181 2441 373 11 -1
3 1 57 1 0 0 181 2441 373 11 -1
4 1 57 1 1 0 181 2441 373 11 -1
5 1 57 1 1 1 181 2441 373 11 95.000000
2 1 58 0 0 0 178 2647 374 12 -1
3 1 58 1 0 0 178 2647 374 12 -1
4 1 58 1 1 0 178 2647 374 12 -1
5 1 58 1 1 1 178 2647 374 12 95.000000
2 1 59 0 0 0 178 1675 22 1091 -1
3 1 59 1 0 0 178 1675 22 1091 -1
4 1 59 1 1 0 178 1675 22 1091 -1
5 1 59 1 1 1 178 1675 22 1091 95.000000
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3 1 60 1 0 0 547 2328 11 437 -1
4 1 60 1 1 0 547 2328 11 437 -1
5 1 60 1 1 1 547 2328 11 437 95.000000
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3 1 61 1 0 0 816 2375 171 8 -1
4 1 61 1 1 0 816 2375 171 8 -1
5 1 61 1 1 1 816 2375 171 8 95.000000
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3 1 62 1 0 0 926 2377 5 79 -1
4 1 62 1 1 0 926 2377 5 79 -1
5 1 62 1 1 1 926 2377 5 79 95.000000
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3 1 63 1 0 0 983 2377 5 80 -1
4 1 63 1 1 0 983 2377 5 80 -1
5 1 63 1 1 1 983 2377 5 80 95.000000
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3 1 64 1 0 0 867 2377 4 79 -1
4 1 64 1 1 0 867 2377 4 79 -1
5 1 64 1 1 1 867 2377 4 79 95.000000
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3 1 65 1 0 0 814 2450 173 8 -1
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3 1 66 1 0 0 799 2670 335 9 -1
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5 1 66 1 1 1 799 2670 335 9 95.000000
2 1 67 0 0 0 799 2637 269 87 -1
3 1 67 1 0 0 799 2637 269 87 -1
4 1 67 1 1 0 799 2637 269 87 -1
5 1 67 1 1 1 799 2637 70 81 0.000000 _
5 1 67 1 1 2 879 2695 71 23 96.832329 Serial
5 1 67 1 1 3 960 2695 54 29 40.913147 (Lot)
5 1 67 1 1 4 1024 2697 44 21 96.507027 No.
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3 1 68 1 0 0 1410 2384 483 14 -1
4 1 68 1 1 0 1410 2384 483 14 -1
5 1 68 1 1 1 1410 2384 483 14 95.000000
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3 1 69 1 0 0 1188 2452 729 22 -1
4 1 69 1 1 0 1188 2452 729 22 -1
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3 1 70 1 0 0 1502 2448 5 131 -1
4 1 70 1 1 0 1502 2448 5 131 -1
5 1 70 1 1 1 1502 2448 5 131 95.000000
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3 1 71 1 0 0 1335 2561 554 16 -1
4 1 71 1 1 0 1335 2561 554 16 -1
5 1 71 1 1 1 1335 2561 554 16 95.000000
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3 1 72 1 0 0 1318 2622 568 15 -1
4 1 72 1 1 0 1318 2622 568 15 -1
5 1 72 1 1 1 1318 2622 568 15 95.000000
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3 1 73 1 0 0 192 2014 1541 689 -1
4 1 73 1 1 0 202 2014 1469 169 -1
5 1 73 1 1 1 202 2051 128 57 93.265450 SPECIES:
5 1 73 1 1 2 421 2014 61 77 65.693573 =
5 1 73 1 1 3 960 2068 66 23 91.041588 SIZE:
5 1 73 1 1 4 1133 2094 9 5 48.829491 .
5 1 73 1 1 5 1206 2043 191 122 31.408333 ane
5 1 73 1 1 6 1299 2070 198 113 32.753147 a
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5 1 73 1 2 7 663 2068 57 68 25.694084 io.
5 1 73 1 2 8 737 2116 25 22 88.985039 to
5 1 73 1 2 9 778 2115 29 23 88.985039 12
5 1 73 1 2 10 825 2115 47 23 94.184547 Mo.
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5 1 73 1 2 14 1089 2092 156 52 0.000000 Inst
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4 1 73 1 3 0 202 2148 1445 36 -1
5 1 73 1 3 1 202 2161 44 23 83.841850 Cat
5 1 73 1 3 2 294 2155 30 29 78.746155 O
5 1 73 1 3 3 421 2160 94 23 94.403709 Female
5 1 73 1 3 4 583 2154 29 29 14.993429 1}
5 1 73 1 3 5 644 2160 201 24 8.601608 12Mo.orolder
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5 1 73 1 3 7 1152 2151 40 33 4.834423 [4
5 1 73 1 3 8 1599 2148 48 27 30.573410 a:
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5 1 73 1 4 1 201 2207 72 24 79.748329 Other
5 1 73 1 4 2 416 2206 94 34 63.676193 Altered
5 1 73 1 4 3 561 2200 56 40 17.389259 S&T
5 1 73 1 4 4 958 2206 61 23 92.259941 Over
5 1 73 1 4 5 1027 2208 32 21 63.792080 50
5 1 73 1 4 6 1071 2206 42 37 80.194489 Ibs.
5 1 73 1 4 7 1150 2200 31 29 44.128418 (1;
5 1 73 1 4 8 1210 2200 88 23 96.894394 NAME:
4 1 73 1 5 0 202 2245 1289 134 -1
5 1 73 1 5 1 202 2260 110 38 96.601395 (Specify)
5 1 73 1 5 2 1200 2245 291 134 0.000000 COED
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5 1 73 1 6 1 202 2349 68 21 96.945282 DATE
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5 1 73 1 6 3 572 2330 174 52 46.546257 PRODUCER:.
5 1 73 1 6 4 1208 2365 171 25 69.350845 Voterinartan's
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5 1 73 1 6 7 1479 2333 98 64 11.088572 Ly,
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5 1 73 1 6 9 1611 2344 39 46 27.234564 0
4 1 73 1 7 0 202 2341 1328 80 -1
5 1 73 1 7 1 202 2383 53 25 76.052330 CA
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5 1 73 1 8 4 873 2388 101 64 49.506317 ie
5 1 73 1 8 5 1477 2334 115 122 23.252640 nee
4 1 73 1 9 0 228 2450 1478 121 -1
5 1 73 1 9 1 228 2450 60 40 76.855705 fonth
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5 1 73 1 9 6 875 2470 15 22 96.527046 3
5 1 73 1 9 7 900 2469 95 29 96.527046 Letters)
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5 1 73 1 9 9 1604 2465 102 106 77.045097 WA
4 1 73 1 10 0 570 2503 900 65 -1
5 1 73 1 10 1 570 2530 9 23 94.071289 1
5 1 73 1 10 2 607 2535 14 17 85.442696 yr.
5 1 73 1 10 3 631 2523 124 30 33.948521 Lic.Vaces
5 1 73 1 10 4 1225 2544 5 5 0.000000 .
5 1 73 1 10 5 1440 2503 30 65 39.854183 {
4 1 73 1 11 0 197 2517 1407 138 -1
5 1 73 1 11 1 197 2558 189 60 18.641357 VAGOINATION
5 1 73 1 11 2 396 2558 124 51 95.398613 EXPIRES:
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5 1 73 1 11 4 742 2517 106 138 21.759815 7
5 1 73 1 11 5 1206 2544 123 27 96.771935 Signature
5 1 73 1 11 6 1414 2571 43 9 22.166710 4
5 1 73 1 11 7 1587 2570 17 18 43.308128 +
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5 1 73 1 12 1 567 2592 15 21 84.815475 3
5 1 73 1 12 2 591 2596 27 23 84.815475 yr.
5 1 73 1 12 3 631 2590 43 23 77.404167 Lic.
5 1 73 1 12 4 675 2590 72 23 12.607527 Wace
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4 1 73 1 13 0 190 2581 1213 93 -1
5 1 73 1 13 1 190 2594 47 37 79.576675 £3
5 1 73 1 13 2 211 2588 63 67 40.711288 Ay
5 1 73 1 13 3 313 2588 89 67 68.648216 BVO
5 1 73 1 13 4 453 2581 59 71 46.323822 I
5 1 73 1 13 5 501 2604 41 45 24.203930 fee
5 1 73 1 13 6 798 2609 123 65 9.257755 Lie
5 1 73 1 13 7 909 2609 120 64 6.401434 CUES
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5 1 73 1 14 7 1302 2628 228 75 38.241386 VEECO
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5 1 73 1 14 9 1691 2657 42 39 37.273399 ri
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3 1 74 1 0 0 1315 2681 568 18 -1
4 1 74 1 1 0 1315 2681 568 18 -1
5 1 74 1 1 1 1315 2681 568 18 95.000000
2 1 75 0 0 0 1185 2029 15 737 -1
3 1 75 1 0 0 1185 2029 15 737 -1
4 1 75 1 1 0 1185 2029 15 737 -1
5 1 75 1 1 1 1185 2029 15 737 95.000000
2 1 76 0 0 0 1911 1674 20 1093 -1
3 1 76 1 0 0 1911 1674 20 1093 -1
4 1 76 1 1 0 1911 1674 20 1093 -1
5 1 76 1 1 1 1911 1674 20 1093 95.000000
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3 1 77 1 0 0 177 2744 1736 39 -1
4 1 77 1 1 0 177 2744 1736 39 -1
5 1 77 1 1 1 177 2744 1736 39 95.000000
2 1 78 0 0 0 177 2780 165 22 -1
3 1 78 1 0 0 177 2780 165 22 -1
4 1 78 1 1 0 177 2780 165 22 -1
5 1 78 1 1 1 177 2780 165 22 86.359764 VAC0410001
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3 1 79 1 0 0 1537 1887 412 77 -1
4 1 79 1 1 0 1537 1887 384 77 -1
5 1 79 1 1 1 1537 1893 100 71 80.854347 UGE
5 1 79 1 1 2 1629 1891 146 61 16.048803 Jee
5 1 79 1 1 3 1783 1887 138 71 14.726210 ROLF
2 1 80 0 0 0 1498 1971 314 80 -1
3 1 80 1 0 0 1498 1971 314 80 -1
4 1 80 1 1 0 1498 1971 314 80 -1
5 1 80 1 1 1 1498 1960 49 52 47.842163 |
5 1 80 1 1 2 1545 1971 267 80 15.727129 BOL
2 1 81 0 0 0 2019 96 452 851 -1
3 1 81 1 0 0 2032 96 367 131 -1
4 1 81 1 1 0 2036 96 363 26 -1
5 1 81 1 1 1 2036 96 216 26 91.836540 VACCINATION
5 1 81 1 1 2 2263 96 136 24 96.291100 RECORD
4 1 81 1 2 0 2037 144 86 26 -1
5 1 81 1 2 1 2037 144 86 26 95.914871 Name
4 1 81 1 3 0 2032 198 157 29 -1
5 1 81 1 3 1 2032 198 31 29 0.000000 CT
5 1 81 1 3 2 2073 201 116 26 0.000000 RABIES
3 1 81 2 0 0 2031 253 270 28 -1
4 1 81 2 1 0 2031 253 270 28 -1
5 1 81 2 1 1 2031 253 123 28 21.665678 LILYME
5 1 81 2 1 2 2167 255 134 26 96.277596 DISEASE
3 1 81 3 0 0 2031 309 354 28 -1
4 1 81 3 1 0 2031 309 354 28 -1
5 1 81 3 1 1 2031 309 29 27 49.138405 LI
5 1 81 3 1 2 2070 311 122 25 92.194046 CANINE
5 1 81 3 1 3 2203 310 182 27 90.210564 DISTEMPER
3 1 81 4 0 0 2028 363 435 140 -1
4 1 81 4 1 0 2029 363 434 30 -1
5 1 81 4 1 1 2029 363 31 29 0.000000 CI
5 1 81 4 1 2 2068 366 122 26 0.000000 CANINE
5 1 81 4 1 3 2202 366 261 27 90.888184 PARAINFLUENZA
4 1 81 4 2 0 2029 419 406 28 -1
5 1 81 4 2 1 2029 419 29 28 86.144020 LJ
5 1 81 4 2 2 2068 421 122 26 86.144020 CANINE
5 1 81 4 2 3 2199 421 209 26 95.909508 ADENOVIRUS
5 1 81 4 2 4 2419 423 16 24 96.727676 2
4 1 81 4 3 0 2028 474 372 29 -1
5 1 81 4 3 1 2028 474 29 29 67.053467 C1
5 1 81 4 3 2 2067 477 122 26 76.488464 CANINE
5 1 81 4 3 3 2200 477 200 26 96.774223 PARVOVIRUS
3 1 81 5 0 0 2025 530 408 88 -1
4 1 81 5 1 0 2026 530 407 28 -1
5 1 81 5 1 1 2026 530 31 28 72.502899 [LI
5 1 81 5 1 2 2065 532 122 26 90.246620 CANINE
5 1 81 5 1 3 2198 532 235 26 95.731071 CORONAVIRUS
4 1 81 5 2 0 2025 585 381 33 -1
5 1 81 5 2 1 2025 585 30 29 46.175426 (J
5 1 81 5 2 2 2064 588 123 26 30.764652 GANINE
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3 1 81 6 0 0 2025 642 293 27 -1
4 1 81 6 1 0 2025 642 293 27 -1
5 1 81 6 1 1 2025 642 29 27 26.312843 C1
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4 1 81 7 1 0 2023 697 427 29 -1
5 1 81 7 1 1 2023 697 31 28 45.027462 (3
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5 1 81 7 2 1 2022 753 30 27 61.408203 (J
5 1 81 7 2 2 2062 754 110 26 86.025978 FELINE
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4 1 81 7 3 0 2022 808 449 28 -1
5 1 81 7 3 1 2022 808 29 28 66.460800 C1
5 1 81 7 3 2 2061 810 110 26 91.470383 FELINE
5 1 81 7 3 3 2182 810 289 26 91.086128 RHINOTRAGHEITIS
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5 1 81 7 4 1 2020 863 31 28 60.748886 CO
5 1 81 7 4 2 2060 865 109 26 60.748886 FELINE
5 1 81 7 4 3 2181 865 198 26 88.947968 CALICIVIRUS
3 1 81 8 0 0 2019 918 351 29 -1
4 1 81 8 1 0 2019 918 351 29 -1
5 1 81 8 1 1 2019 918 30 29 21.276560 CO
5 1 81 8 1 2 2059 921 109 26 21.276560 FELINE
5 1 81 8 1 3 2179 921 191 26 95.392380 CHLAMYDIA
2 1 82 0 0 0 2019 975 483 75 -1
3 1 82 1 0 0 2019 975 483 75 -1
4 1 82 1 1 0 2019 975 483 29 -1
5 1 82 1 1 1 2019 975 29 27 56.157261 LC
5 1 82 1 1 2 2058 976 110 26 66.875557 FELINE
5 1 82 1 1 3 2179 976 323 28 90.014359 IMMUNODEFICIENCY
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5 1 82 1 2 1 2057 1024 96 26 95.344604 VIRUS
2 1 83 0 0 0 2131 168 333 8 -1
3 1 83 1 0 0 2131 168 333 8 -1
4 1 83 1 1 0 2131 168 333 8 -1
5 1 83 1 1 1 2131 168 333 8 95.000000
2 1 84 0 0 0 2076 1125 257 81 -1
3 1 84 1 0 0 2083 1125 250 81 -1
4 1 84 1 1 0 2148 1125 185 39 -1
5 1 84 1 1 1 2148 1125 185 39 96.429092 Boehringer
4 1 84 1 2 0 2076 1132 239 74 -1
5 1 84 1 2 1 2076 1132 36 71 57.042686 i
5 1 84 1 2 2 2147 1167 168 39 95.779953 Ingelheim
2 1 85 0 0 0 2004 1674 488 957 -1
3 1 85 1 0 0 2019 1674 362 27 -1
4 1 85 1 1 0 2019 1674 362 27 -1
5 1 85 1 1 1 2019 1674 213 27 92.001625 VACCINATION
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3 1 85 2 0 0 2020 1725 373 26 -1
4 1 85 2 1 0 2020 1725 373 26 -1
5 1 85 2 1 1 2020 1725 85 26 96.137047 Name
5 1 85 2 1 2 2382 1731 11 15 0.000000 N
3 1 85 3 0 0 2016 1779 417 30 -1
4 1 85 3 1 0 2016 1779 417 30 -1
5 1 85 3 1 1 2016 1779 29 27 82.541733 LJ
5 1 85 3 1 2 2055 1782 116 24 82.541733 RABIES
5 1 85 3 1 3 2415 1779 18 30 60.065174 \
3 1 85 4 0 0 2014 1833 269 29 -1
4 1 85 4 1 0 2014 1833 269 29 -1
5 1 85 4 1 1 2014 1833 124 29 46.664181 CILYME
5 1 85 4 1 2 2149 1836 134 26 96.350471 DISEASE
3 1 85 5 0 0 2014 1888 353 29 -1
4 1 85 5 1 0 2014 1888 353 29 -1
5 1 85 5 1 1 2014 1888 29 29 86.338875 O
5 1 85 5 1 2 2052 1891 122 26 91.250389 CANINE
5 1 85 5 1 3 2185 1891 182 26 90.791054 DISTEMPER
3 1 85 6 0 0 2013 1944 434 29 -1
4 1 85 6 1 0 2013 1944 434 29 -1
5 1 85 6 1 1 2013 1944 30 29 73.216965 CU
5 1 85 6 1 2 2052 1947 120 26 73.216965 CANINE
5 1 85 6 1 3 2185 1947 262 26 78.070259 PARAINFLUENZA
3 1 85 7 0 0 2011 1999 407 29 -1
4 1 85 7 1 0 2011 1999 407 29 -1
5 1 85 7 1 1 2011 1999 31 29 34.189144 CI
5 1 85 7 1 2 2050 2002 122 26 34.189144 CANINE
5 1 85 7 1 3 2181 2002 210 26 95.609810 ADENOVIRUS
5 1 85 7 1 4 2401 2002 17 25 96.923431 2
3 1 85 8 0 0 2011 2055 373 29 -1
4 1 85 8 1 0 2011 2055 373 29 -1
5 1 85 8 1 1 2011 2055 29 29 64.858406 CI
5 1 85 8 1 2 2049 2058 122 26 64.858406 CANINE
5 1 85 8 1 3 2182 2058 202 26 96.587181 PARVOVIRUS
3 1 85 9 0 0 2010 2110 407 29 -1
4 1 85 9 1 0 2010 2110 407 29 -1
5 1 85 9 1 1 2010 2110 30 29 41.555332 L)
5 1 85 9 1 2 2049 2113 122 26 96.758827 CANINE
5 1 85 9 1 3 2181 2113 236 26 42.297714 CORONAVIRUS
3 1 85 10 0 0 2010 2166 381 29 -1
4 1 85 10 1 0 2010 2166 381 29 -1
5 1 85 10 1 1 2010 2166 29 29 39.334610 []
5 1 85 10 1 2 2047 2169 122 26 95.901413 CANINE
5 1 85 10 1 3 2181 2169 210 26 96.052361 BORDETELLA
3 1 85 11 0 0 2008 2221 293 29 -1
4 1 85 11 1 0 2008 2221 293 29 -1
5 1 85 11 1 1 2008 2221 31 29 19.193516 CI
5 1 85 11 1 2 2047 2224 254 26 19.193516 LEPTOSPIROSIS
3 1 85 12 0 0 2008 2277 427 29 -1
4 1 85 12 1 0 2008 2277 427 29 -1
5 1 85 12 1 1 2008 2277 29 29 37.458920 CO
5 1 85 12 1 2 2047 2281 109 25 46.198925 FELINE
5 1 85 12 1 3 2167 2280 163 26 96.313545 LEUKEMIA
5 1 85 12 1 4 2338 2280 97 26 96.011162 VIRUS
3 1 85 13 0 0 2007 2334 428 27 -1
4 1 85 13 1 0 2007 2334 428 27 -1
5 1 85 13 1 1 2007 2334 29 27 65.829254 CI
5 1 85 13 1 2 2046 2335 108 26 66.459038 FELINE
5 1 85 13 1 3 2166 2335 269 26 89.583832 PANLEUKOPENIA
3 1 85 14 0 0 2005 2389 451 29 -1
4 1 85 14 1 0 2005 2389 451 29 -1
5 1 85 14 1 1 2005 2389 31 28 64.557182 CO
5 1 85 14 1 2 2045 2391 109 27 74.072029 FELINE
5 1 85 14 1 3 2166 2391 290 26 67.737541 RHINOTRACHEITIS
3 1 85 15 0 0 2005 2445 358 27 -1
4 1 85 15 1 0 2005 2445 358 27 -1
5 1 85 15 1 1 2005 2445 29 27 56.562405 LI
5 1 85 15 1 2 2044 2447 109 25 56.562405 FELINE
5 1 85 15 1 3 2164 2446 199 26 52.527634 CAUICIVIRUS
3 1 85 16 0 0 2004 2499 350 29 -1
4 1 85 16 1 0 2004 2499 350 29 -1
5 1 85 16 1 1 2004 2499 30 29 38.609390 (1
5 1 85 16 1 2 2044 2502 109 26 93.792229 FELINE
5 1 85 16 1 3 2163 2502 191 26 96.210175 CHLAMYDIA
3 1 85 17 0 0 2004 2556 488 75 -1
4 1 85 17 1 0 2004 2556 488 27 -1
5 1 85 17 1 1 2004 2556 29 27 73.768692 LI
5 1 85 17 1 2 2043 2557 108 26 53.029209 FELINE
5 1 85 17 1 3 2163 2557 329 26 93.938416 IMMUNODEFICIENCY
4 1 85 17 2 0 2042 2606 96 25 -1
5 1 85 17 2 1 2042 2606 96 25 96.101974 VIRUS
2 1 86 0 0 0 2115 1746 332 11 -1
3 1 86 1 0 0 2115 1746 332 11 -1
4 1 86 1 1 0 2115 1746 332 11 -1
5 1 86 1 1 1 2115 1746 332 11 95.000000
2 1 87 0 0 0 2062 2706 254 81 -1
3 1 87 1 0 0 2070 2706 246 81 -1
4 1 87 1 1 0 2133 2706 183 39 -1
5 1 87 1 1 1 2133 2706 183 39 96.295639 Boehringer
4 1 87 1 2 0 2062 2713 236 74 -1
5 1 87 1 2 1 2062 2713 35 71 45.006729 i}
5 1 87 1 2 2 2132 2748 166 39 95.728729 Ingelheim
2 1 88 0 0 0 2544 65 6 226 -1
3 1 88 1 0 0 2544 65 6 226 -1
4 1 88 1 1 0 2544 65 6 226 -1
5 1 88 1 1 1 2544 65 6 226 95.000000
2 1 89 0 0 0 2516 425 34 2862 -1
3 1 89 1 0 0 2516 425 34 2862 -1
4 1 89 1 1 0 2516 425 34 2862 -1
5 1 89 1 1 1 2516 425 34 2862 95.000000
mn ,
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oo veterans NY }
1 ye. Lic. Avace, ay
VACCINATION EXPIRES: Signature_ \ .
3 yr. Lic.Vace. 5 1 30 2 1 2 1521 1012 9 35 83.282791 \
5 1 30 2 1 3 1566 1050 25 14 3.518314 °
2 1 31 0 0 0 216 114 1748 789 -1
3 1 31 1 0 0 216 114 1748 789 -1
4 1 31 1 1 0 349 114 1346 45 -1
5 1 31 1 1 1 349 114 8 11 14.125776 ,
5 1 31 1 1 2 702 123 152 32 95.752106 RABIES
5 1 31 1 1 3 865 123 283 32 62.834373 VACCINATION
5 1 31 1 1 4 1162 123 266 33 0.000000 CERTIFICATE
5 1 31 1 1 5 1571 132 45 27 96.440872 Tag
5 1 31 1 1 6 1625 130 39 23 93.303360 fee
5 1 31 1 1 7 1672 129 23 27 93.065399 $:
4 1 31 1 2 0 220 177 1426 41 -1
5 1 31 1 2 1 220 177 10 11 80.233765 .
5 1 31 1 2 2 806 180 178 38 93.176147 ADAPTED
5 1 31 1 2 3 994 180 155 29 91.561600 NASPHV
5 1 31 1 2 4 1155 181 110 34 95.445351 FORM
5 1 31 1 2 5 1273 180 38 29 91.874756 51
5 1 31 1 2 6 1570 177 44 27 91.969711 Tag
5 1 31 1 2 7 1624 177 22 21 83.182945 #:
4 1 31 1 3 0 226 220 1517 40 -1
5 1 31 1 3 1 226 234 106 24 95.313629 Owner's
5 1 31 1 3 2 340 235 76 25 93.260292 Name
5 1 31 1 3 3 424 237 17 23 93.163940 &
5 1 31 1 3 4 448 237 109 23 96.440086 Address
5 1 31 1 3 5 865 231 91 20 92.885162 PRINT
5 1 31 1 3 6 942 223 12 36 92.885162 -
5 1 31 1 3 7 964 235 41 14 96.572327 use
5 1 31 1 3 8 1014 231 41 18 88.750755 ball
5 1 31 1 3 9 1063 231 61 23 95.887573 point
5 1 31 1 3 10 1131 237 42 18 96.039825 pen
5 1 31 1 3 11 1182 237 24 14 96.549210 or
5 1 31 1 3 12 1212 234 51 21 95.020317 type
5 1 31 1 3 13 1570 222 59 23 94.356415 Cert,
5 1 31 1 3 14 1641 220 71 25 51.162792 Serial
5 1 31 1 3 15 1722 222 21 21 82.609459 #:
4 1 31 1 4 0 216 291 1712 54 -1
5 1 31 1 4 1 216 291 93 30 78.999596 PRINT
5 1 31 1 4 2 318 291 69 24 95.238876 LAST
5 1 31 1 4 3 616 294 109 30 0.000000 wgBIAST
5 1 31 1 4 4 1339 292 29 26 66.151192 Mi
5 1 31 1 4 5 1567 294 170 51 84.625084 TELEPHONE
5 1 31 1 4 6 1829 313 99 20 28.214388 ih
4 1 31 1 5 0 223 294 1741 120 -1
5 1 31 1 5 1 223 313 76 100 42.822876 te
5 1 31 1 5 2 309 325 155 89 56.392548 (ce
5 1 31 1 5 3 624 294 51 79 52.184479 Ec
5 1 31 1 5 4 675 315 257 54 0.000000 CAGHDON
5 1 31 1 5 5 1576 318 233 53 0.000000 YWO~LES
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a mae wenee may pen om pen VACCINATION RECORD ~
RABIES VACCINATION CERTIFICATE TegtesS:
a
ADAPTED NASPHV FORM 51 Tag #;
CORABIES
Owner’s Name & Address PRINT - use ball paint pen or type Cert. ert, Serial Serial # #
SILYME DISEASE
PRINT LAS ! FIRST; Ml TELEPHONE
| ore 2. e CA Sti LEY 5593 So Wf CANINE DISTEMPER
.
a CANINE PARAINFLUENZA
NOs STAKE g 9
1 STREET Calle 4 | Gad
5 1 35 1 10 9 1129 391 65 50 24.873114 qld
5 1 35 1 10 10 1122 391 72 63 77.380814 alu
5 1 35 1 10 11 1225 417 147 56 33.008102 CF
5 1 35 1 10 12 1389 409 41 37 86.047630 2
5 1 35 1 10 13 1704 386 63 67 37.327576 £3
5 1 35 1 10 14 2014 405 28 29 30.537914 CI
5 1 35 1 10 15 2052 409 119 26 30.537914 CANINE
5 1 35 1 10 16 2181 409 212 26 96.739571 ADENOVIRUS
5 1 35 1 10 17 2404 409 16 25 96.891365 2
4 1 35 1 11 0 199 403 2186 125 -1
5 1 35 1 11 1 199 471 127 42 94.179459 SPECIES:
5 1 35 1 11 2 373 454 32 63 51.897346 |
5 1 35 1 11 3 417 471 60 23 95.624161 SEX:
5 1 35 1 11 4 631 456 73 61 92.031876 AGE:
5 1 35 1 11 5 957 472 66 23 94.802170 SIZE:
5 1 35 1 11 6 1197 403 196 125 35.327179 plese
5 1 35 1 11 7 1405 474 91 23 95.189804 BREED:
5 1 35 1 11 8 1521 459 16 58 91.043236 |
5 1 35 1 11 9 1546 474 125 39 51.008217 COLORS:
5 1 35 1 11 10 2013 460 29 29 0.000000 CJ
5 1 35 1 11 11 2050 463 121 28 0.000000 CANINE
5 1 35 1 11 12 2182 465 203 26 96.713684 PARVOVIRUS
4 1 35 1 12 0 199 501 2219 66 -1
5 1 35 1 12 1 199 516 52 29 79.056190 Dog
5 1 35 1 12 2 288 504 45 45 39.043388 pel
5 1 35 1 12 3 418 508 61 46 96.906052 Male
5 1 35 1 12 4 582 513 39 29 51.347488 Ri]
5 1 35 1 12 5 639 519 15 21 69.877274 3
5 1 35 1 12 6 670 519 47 21 93.061165 Mo.
5 1 35 1 12 7 733 520 25 20 94.713821 to
5 1 35 1 12 8 775 519 29 21 94.713821 12
5 1 35 1 12 9 822 519 47 23 94.525543 Mo.
5 1 35 1 12 10 898 513 29 29 68.748657 0
5 1 35 1 12 11 948 519 87 42 66.392860 ‘Under
5 1 35 1 12 12 1045 519 31 23 96.572121 20
5 1 35 1 12 13 1088 519 43 23 96.347717 Ibs.
5 1 35 1 12 14 1150 509 40 33 54.426331 fap
5 1 35 1 12 15 1233 502 62 55 37.616230 aa
5 1 35 1 12 16 1296 508 57 47 74.428314 wt
5 1 35 1 12 17 1350 514 176 53 0.000000 tudes
5 1 35 1 12 18 1604 502 10 53 68.531693 \
5 1 35 1 12 19 1639 501 43 42 32.059166 ry
5 1 35 1 12 20 2013 516 27 29 29.143337 (i
5 1 35 1 12 21 2050 520 119 26 91.071228 CANINE
5 1 35 1 12 22 2181 519 237 27 96.596603 CORONAVIRUS
4 1 35 1 13 0 199 556 2194 46 -1
5 1 35 1 13 1 199 562 44 23 90.933907 cat
5 1 35 1 13 2 291 556 30 29 32.339523 OO
5 1 35 1 13 3 417 558 95 37 96.385933 Female
5 1 35 1 13 4 582 558 27 29 0.000000 |
5 1 35 1 13 5 631 564 38 38 64.671371 je
5 1 35 1 13 6 682 564 46 23 96.342659 Mo.
5 1 35 1 13 7 741 570 26 17 96.840408 or
5 1 35 1 13 8 775 564 67 23 95.702797 older
5 1 35 1 13 9 897 559 200 29 0.000000 Ai720-50lbs
5 1 35 1 13 10 1150 559 29 29 0.000000 €
5 1 35 1 13 11 1484 561 27 6 65.137703 _
5 1 35 1 13 12 2011 571 29 29 0.000000 CI
5 1 35 1 13 13 2049 576 120 26 0.000000 CANINE
5 1 35 1 13 14 2181 576 212 24 95.309143 BORDETELLA
4 1 35 1 14 0 198 597 2090 35 -1
5 1 35 1 14 1 198 607 45 23 88.539803 Other
5 1 35 1 14 2 294 603 29 27 71.890755 O
5 1 35 1 14 3 582 598 48 32 57.622574 fy
5 1 35 1 14 4 712 597 2 2 0.000000 ,
5 1 35 1 14 5 1209 606 86 26 89.354630 NAME:
4 1 35 1 15 0 244 604 2059 77 -1
5 1 35 1 15 1 244 613 34 58 0.000000 i“
5 1 35 1 15 2 414 609 93 23 67.336746 Altered
5 1 35 1 15 3 550 599 16 48 12.042074 —
5 1 35 1 15 4 580 604 31 37 23.052111 &}
5 1 35 1 15 5 955 610 61 23 93.497719 Over
5 1 35 1 15 6 1026 612 32 21 70.145615 50
5 1 35 1 15 7 1068 610 44 23 70.145615 tbs.
5 1 35 1 15 8 1149 606 29 27 8.297014 1
5 1 35 1 15 9 1213 629 116 48 35.170929 Cc
5 1 35 1 15 10 1336 643 37 38 0.955505 CO
5 1 35 1 15 11 2011 628 292 37 17.968121 CLEPTOSPIROSIS
4 1 35 1 16 0 199 662 2239 56 -1
5 1 35 1 16 1 199 662 110 56 94.642990 (Specify)
5 1 35 1 16 2 1354 675 11 5 0.000000 :
5 1 35 1 16 3 2010 684 146 27 0.000000 OFELINE
5 1 35 1 16 4 2169 685 162 26 96.569901 LEUKEMIA
5 1 35 1 16 5 2340 685 98 26 96.556610 VIRUS
4 1 35 1 17 0 730 738 1708 32 -1
5 1 35 1 17 1 730 756 5 5 30.387983 .
5 1 35 1 17 2 1455 738 50 32 30.510426 ‘ae
5 1 35 1 17 3 2010 739 29 28 19.687195 (J
5 1 35 1 17 4 2048 742 108 25 89.568848 FELINE
5 1 35 1 17 5 2167 741 271 27 68.938866 PANLEUKOPENIA
4 1 35 1 18 0 199 725 1432 145 -1
5 1 35 1 18 1 199 748 70 95 0.000000 “S
5 1 35 1 18 2 264 748 216 98 35.668484 “oo
5 1 35 1 18 3 570 731 176 56 65.547417 PRODUCER:.
5 1 35 1 18 4 1207 771 172 23 64.286652 Veterinarian's
5 1 35 1 18 5 1388 772 15 22 91.509689 #
5 1 35 1 18 6 1506 725 105 145 24.621296 me
5 1 35 1 18 7 1595 733 36 60 60.544674 by
4 1 35 1 19 0 838 781 1621 79 -1
5 1 35 1 19 1 838 796 74 50 38.210236 Qe
5 1 35 1 19 2 943 781 43 79 40.805954 Ss
5 1 35 1 19 3 1408 802 100 23 48.978317 Licen¢e
5 1 35 1 19 4 2008 795 146 38 42.664814 CIFELINE
5 1 35 1 19 5 2167 796 292 26 91.707451 RHINOTRACHEITIS
4 1 35 1 20 0 195 808 1496 173 -1
5 1 35 1 20 1 195 958 168 23 88.020966 VACCINATIO
5 1 35 1 20 2 513 966 5 5 9.578266 .
5 1 35 1 20 3 568 933 10 23 77.253433 4
5 1 35 1 20 4 590 939 28 23 88.618202 yr.
5 1 35 1 20 5 631 933 41 23 70.519745 Lic.
5 1 35 1 20 6 681 929 71 37 64.194572 Vace,
5 1 35 1 20 7 762 912 51 66 33.156700 ig
5 1 35 1 20 8 1206 948 120 27 96.512779 Signature
5 1 35 1 20 9 1513 808 178 164 39.870224 I
4 1 35 1 21 0 219 954 2277 54 -1
5 1 35 1 21 1 219 997 5 5 72.127602 A
5 1 35 1 21 2 360 954 23 39 46.134495 iN
5 1 35 1 21 3 394 955 101 53 70.032043 EXPIRE}
5 1 35 1 21 4 2007 960 146 29 36.349396 (FELINE
5 1 35 1 21 5 2166 963 330 26 95.648842 IMMUNODEFICIENCY
4 1 35 1 22 0 223 980 1918 94 -1
5 1 35 1 22 1 223 996 38 56 91.544731 3
5 1 35 1 22 2 317 980 87 71 62.292973 NG
5 1 35 1 22 3 466 996 11 44 89.730255 \
5 1 35 1 22 4 565 994 14 22 45.810410 3
5 1 35 1 22 5 586 983 31 43 45.810410 yr.
5 1 35 1 22 6 628 988 242 86 0.000000 veneceUE|
5 1 35 1 22 7 874 1014 55 56 53.333679 So
5 1 35 1 22 8 952 1002 85 66 43.717152 LS
5 1 35 1 22 9 1038 988 42 71 53.135582 /s
5 1 35 1 22 10 1204 1008 106 23 94.835541 Address
5 1 35 1 22 11 1447 1038 7 6 14.136581 _
5 1 35 1 22 12 1597 1018 110 37 0.000000 a
5 1 35 1 22 13 2045 1011 96 26 95.731979 VIRUS
4 1 35 1 23 0 195 1035 1554 58 -1
5 1 35 1 23 1 195 1063 81 23 95.461266 Month
5 1 35 1 23 2 352 1064 49 28 96.872589 Day
5 1 35 1 23 3 465 1065 57 23 96.354973 Year
5 1 35 1 23 4 991 1044 52 23 25.784439 aon
5 1 35 1 23 5 1366 1038 167 55 64.289230 Vert
5 1 35 1 23 6 1602 1054 32 37 92.491142 3
5 1 35 1 23 7 1687 1050 16 39 30.060329 é
5 1 35 1 23 8 1713 1035 36 51 0.000000 S
4 1 35 1 24 0 798 1099 1521 52 -1
5 1 35 1 24 1 798 1099 69 22 90.907944 Vacc.
5 1 35 1 24 2 877 1099 71 23 96.903503 Serial
5 1 35 1 24 3 958 1099 56 29 95.074287 {Lot}
5 1 35 1 24 4 1024 1099 43 23 96.563347 No.
5 1 35 1 24 5 2071 1118 23 13 61.534645 ~~
5 1 35 1 24 6 2136 1113 21 30 78.414116 B
5 1 35 1 24 7 2161 1111 158 40 88.838158 oehringer
4 1 35 1 25 0 2065 1132 236 61 -1
5 1 35 1 25 1 2065 1132 35 58 60.064720 ih
5 1 35 1 25 2 2136 1153 165 40 80.696571 Ingelheim
2 1 36 0 0 0 173 76 21 1091 -1
3 1 36 1 0 0 173 76 21 1091 -1
4 1 36 1 1 0 173 76 21 1091 -1
5 1 36 1 1 1 173 76 21 1091 95.000000
2 1 37 0 0 0 544 730 12 437 -1
3 1 37 1 0 0 544 730 12 437 -1
4 1 37 1 1 0 544 730 12 437 -1
5 1 37 1 1 1 544 730 12 437 95.000000
2 1 38 0 0 0 175 1145 1741 43 -1
3 1 38 1 0 0 175 1145 1741 43 -1
4 1 38 1 1 0 175 1145 1741 43 -1
5 1 38 1 1 1 175 1145 1741 43 95.000000
2 1 39 0 0 0 175 1180 164 23 -1
3 1 39 1 0 0 175 1180 164 23 -1
4 1 39 1 1 0 175 1180 164 23 -1
5 1 39 1 1 1 175 1180 164 23 77.238663 VAC0410001
2 1 40 0 0 0 2516 782 34 2509 -1
3 1 40 1 0 0 2516 782 34 2509 -1
4 1 40 1 1 0 2516 782 34 2509 -1
5 1 40 1 1 1 2516 782 34 2509 95.000000 mec)
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