FOREVER FAITHFUL - PART 2.PDF

Pet Clinic, LLC
' \ RABIES VACCINATION CERTIFICATE Tag fee 5: school Rd., #108
AZ 85033
ADAPTED NASPFIV FORM 51 Tag it: 46-3979
Owner's Name & Address PRINT - use half point pen or type Cert. Serial If:
PRINT LAST FIR! Tj _MI TELEPHONE
--lanit 1 LAd v V-cort ver -1--Q.Mykl W-3 2 IU Il.1)al_ iome Phone .
NO. STRE.ET i CITY i STATE ZIP
0 d_i (Jou-- _ Day Phone -
SPECI Sr SEX: AG!: SIZE: I PREDOMINANT BREED: COLORS:
Dog Male 1,---(I 1o. TO 12 Mo. 7 Under 20 lbs. 0 h,'
Cat .__ Female L 12 Mo, or older 20 - 50 lbs
Other .:2 Altered Over 50 lbs. 17 NAME 1_,
(Specify)
.1.3 Cat U Male D Female Ago
DATE VACCINATED: PRODUCER: /Allergies?
Veterinarian's if 1M S--
4-I 3 0 1 '--- License No. VSneezing U Appetite change
Month Day Year (Fi rs t 3 Letters) - i
Veterinarian's
VACCiNATION EXPIRES: 1 yr. Lic.Nacc. Signature _
30 3 yr. Lic.Nacc. n . Address
Month Day Year 1 j o 1 ./ %-- go (. 1, 1 I ir\rfc-
Vacc. Serial (Lot) No. 7 112 W. 11141-at44:00-04fk -R-Ste 108
Phoenix, AZ 85033
-
_eukemia tested ID Stray (past or present)
Has your pet ever been vaccinated? Li Yes 0 No If Yes, in which month of this past year? Has it been over 1 year? 1_J Yes Li No
Check those which apply Dog: U Parvo/Distemper combo U Bordetella ID Rabies (Mo/Year)
Cat: U FVRCP U Feline Leukemia Ii FIP D Rabies (MoNear)
I hereby authorize the following: Di SPAY (Female) ID NEUTER (Male) U Declaw You are to use all reasonable precautions against injury, escape,
or death of my pet, but you will not be held liable Or responsible
in any manner in connection therewith as 11 is thoroughly under-
U Dental U Nail Trim Li Ear Mite Treatment Li Vaccinations stood that I assume all risks. I am aware that you are not a 24
hour care facility.
U Pain Med. ID Lab Li Other X
Do NOT Signature of Legal Oker or Authorized Person
Service $
5: 13 BAR 0.:10THER: Spay/Neut $
0: WNL (SEE BELOW)
A: APP.HEALTHY 0 OTHER: tit jkl1r811111 Declaw $
P: Sx 0 Vx 0 TNT 0 FAG 0 VAC $
Nail Trim $
Dental $
Recovery Status . Heat/Preg $
Weight Temp: P R / P R / P Cryptorchid$
Meds $
Vaccinations Given .
Ear mite Tx $
Medication Given .
Lab $
Rx:
Veterinarian Signature:
Coupons
Booster Vacs needed in 3 Weeks Li Annual Vacs in 1 year ID Return for suture removal (10-14 days)
=I Return in 6 mo. refill heartworm med. Testing: FELV FIV Heartwarm TOTAL $
V-in FEE FOR REPLACEMENT COPY OF LOST RECORDS.

RABIES VAC INAi C.E.:R77,-PCATE 74prit 7C_
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Name &Accre_ss
Age
DINATED:
Day Year !7 7
vtifloTs'
,
Phoenix, AZ 85033
623-846-'39 79
—P 00Ifl inaoorfoutdoor U FeraW/Pd U Leukemia
Has your pet ever been vaccinated? U Yes 7..] No If Yes, in which month of this past year? Has it been Clief 1 year? -
Check those which apply Dog: Ji Parvo/Distem per combo 0 Bordetella U Rabies (MoNear)
Cat: U FVRCP 0 Feline Leukemia LI FIP 0 Rabies (MoNear)
I hereby authorize the following: U SPAY (Female) Li NEUTER (Male) ID Declaw You are to use all reasonable precautions aoakist
or death of my pet, but you will not be held liab'e
in any manner in connection therewith as it is Mcvo..: _
U Dental ID Nail Trim Cr Ear Mite Treatment ED Vaccinations stood that I assume all risks, t am aware that you z•
hour care facility.
Pain Med. ULab CI Other
DO NOT WRITE B_JOW -N- A-011&- Signature at (031 Owner or Authorized Persdn
111A(1,11 21.29,1P31111 Service _$
Spay/Neut $
S: r5 Declaw $
0: \ANL (13EE. 17E1_0 ) VAC $
APP.1.--EAU',-N 0 OTHLR: • Type7:Paraltalluen Nail Trim $
Sx 0 VY CT. TNTL.i .AGO 9 PervovirusVaCcine 5_i, Dental $
fl.r"V.Socr•-•,.nla US:Valk.1.10,0 tRD'54 1a1gA,
tue,7Vaere.
Heat/Preg $
iecovery Status'
Cryptorchid$
Veight_4,L 1 - • Temp • , / P R / P R
Meds $
/accinations Given .
Ear mite Tx $
iledication Given*
Lab
Veterinarian Signature:
Coupons (-)$
Booster Vacs needed in 3fleeks Di Annual Vacs in 1 year 0 Return for suture removal (10-14 days)
_I Return in 6 mo. refill heartworm med. Testing: FELV FIV Heartworm TOTAL
et•—r00 CCC Orlrl OCDI APCII/ICKIT r.rlDv rip I nqi- PFrOPIng

Indian School Pet Clinic, LLC
7342 W. Indian School Rd., #108
Phoenix, AZ 85033
(623) 846-3979
Home Phone:
Stale Zip Day Phone:
C
51 • C
type cc C +) Li Dog U Cat Li Male 0 Female Age
FORM or
pen Disabilities/Allergies?
point Ui g U Diarrhea U Coughing/Sneezing U Appetite change
NASPHV ll No.
ba her .-._
use 0 (Lot)
Letters)
Serial
ADAPTED 3 on, or anesthesia?
(First Vacc.
older
0 or
Mo, 4.
12 or/outdoor Ll Feral/Wild Li Leukemia tested 0 Stray (past or present)
PRODUCER:
month of this past year? Has it been over 1 year? 0 Yes 0 No
Add Bordetella U Rabies (MoNear)___/
&
Name VACCINATED: la D HP U Rabies (Mo/Year) /
DIL,D
Owner's CL Lu (.5 a. VAC0410001 Vlale) U Declaw You are to use all reasonable precautions against injury, escape,
co 0 0 0 5 or death of my pet, but you will not be held liable or responsible
in any manner in connection therewith as it is thoroughly under-
stood that 1 assume all risks. I am aware that you are not a 24
hour care facility.
U Pain Med. U Lab U Other:
130 N1311- wERN —rtg. EtEH_cavu -1- 1-11P:S [ Signature al Legal Owner or Authorized Person
Service $
BAR -•1:3 OTHER: Spay/Neut $
0: WNL (SEE BELOW)
A: APP.HEALTHY j:1 OTHER: Declaw $
P: .Sx 0 VxLJ Mci r D EAG VAC
Nail Trim $
Dental $
Recovery Status: Heat/Preg $
Weight .- , , Temp. P R / P R / P R Cryptorchid $
Vaccinations Given . Meds $
Medication Given . Ear mite Tx $
Rx . Lab
Veterinarian Signature .
U Booster Vacs needed in 3 Weeks U Annual Vacs in 1 year U Return for suture removal (10-14 days) Coupons (-)$
U Return in 6 mo. refill heartworm med. Testing: FELV FIV Heartworm TOTAL
S70 FEE FOR RFPI ArFNIFNT rrIPV nr riQT rnprIc

_ Clinic, LLC
RABIES VACCINATION CERTIFICATE Tag fee $: ciol Rd., #108
85033
ADAPTED NASPHV FORM 51 Tag It: 3979
Owner's Name & Address PAINT - use ball point pen or type Cert. Serial #:
PRINT Lis=i4 , FIRST i A MI TELEPHONE
a me,i it _ 4 01v Lo "2:3 R)D )022 ne Phone:
NO. Po ST,BEET / CITY ,., 1 STATE
.13by —7 - 7 S- t )0 r.le a v ffS 33% ay Phone:
SPECIES: SEX: AGE: SIZE: PRED IINANT BREED: COLORS:
Dog Male I: 3 Mo. to 12 Mo. Eli Under 20 lbs il
Cat 0 Female 12 Mo. or older :g;) 20 - 50 fbs 0 C.-h 1_ -+ citi-
Other El Altered Over 50 lbs. 0 NAME:
(Specify)
at Ij Male 3 Female Age
DATE VACCINATED: PRODUCER: lergies9
Veterinarian's # 1 k
ao e License No. - neezing ID Appetite change
Month Day Year (First 3 Letters)
Veterinarian's
VACCINATION EXPIRES: 1 yr. Lic.Nacc. Signa ture, c-, ... kr t i• .- : ' : .: C' • ' ,
& 1 D....) . Li 3 yr. Lic.Nacc. l:
Address 7':J.? VII. lii , !id,, SOOCJI Rd.,
Month Day Year 1 ON LIO0 A- Piloatix, AZ. ,a5033
Vacc. Serial (Lot) No. be!3-1S4b- 9M
•--- - • --- -
Tnia tested 3 Stray (past or present)
Has your pet ever been vaccinated? 0 Yes U No If Yes, in which month of this past year? Has it been over 1 year? 3 Yes ID No
Check those which apply Dog: 0 Parvo/Distemper combo 0 Bordetella U Rabies (Mo/Year)
Cat: U FVRCP U Feline Leukemia ID FIP U Rabies (Mo/Year)
I hereby authorize the following: Ui SPAY (Female) 0 NEUTER (Male) 0 Declaw You are to use all reasonable precautions against injury, escape,
or death of my pet, but you will not be held liable or responsible
13 Dental 0 Nail Trim CI Ear Mite Treatment LI Vaccinations stood in any that manner I assume in connection all risks. therewith I am aware as That it is thoroughly you are not under- a 24
hour care facility.
0 Pain Med. 13 Lab-. ID Other X
Do nicrr M—fi SFL. h'-k.0 PE- Signature of Legal Owner or Authorized Person
ci C
Service $
S: Fs BAR . 0 OTHER: . _ Spay/Neut $
0: WNL (SEE BELOW)
AI APP.HEALTHY,..Z OTHER: Deolaw $
P: SY, 0 WZ nift- 0 EAG VAC '1
Nail Trim $
Dental $
Recovery Status' Heat/Preg $
, y Cryptorchid $
Weight / Temp'. '' P R ' / P R / P R
Vaccinations Given' Mods $
Medication Given' Ear mite Tx $
Rx- Lab
Veterinarian Signature.
Ii Booster Vacs needed in 3 Weeks U Annual Vacs in 1 year IA Return for suture removal (10-14 days) Coupons (-)$
0 Return in 6 mo. refill heartworm med. Testing: FELV FIV Heartworm TOTAL
S7cA, FEE FOR REP! ArFIVIFNT rnpv rw I ORT PFCYIRnS

t Clinic, LLC
RABIES VACCINATION CERTIFICATE Tad fee $: fool Pd., #108
ADAPTED NASPHV FORM 51 Tag fl: 85033
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial #: ,3979
PRINT .AST FIRST MI TELEPHONE
•..9W
NO. STREET STREET CIy STATE ZIP no Phone:L_
.X' 7r - oc e a-y- T 8t4 F(EE Wr.3) ay Phone:_..
SPECIES: SEX AGE: SIZE: PREDOMINANT 13: COLORS:
Dog , Mate '''' 3 Mo. to 12 Mo. L. Under 20 lbs. U ' U-P ' )‹ /9/-77Tet,
Cat ' r] Female Ell 12 Mo. or older .7... ' 20 - 50 lbs Ei
Other u Altered Over 50 lbs. NAME:
(Specify) , 'I
at ID Male U Female Age
DATE VACCINATED: PRODUCER: Veterinarian's ti /6 c!I:j (orgies?
-,-)---iii //s- /-_--7... License No.
Month Day Year {First 3 Letters) neezing 0 Appetite change
Veterinarian's
VACCINATION EXPIRES: 1 yr. Lic.Nacc. Signature
,?- /II ii 6' 3 yr. Lic.Nacc. E Addris4-',A A st::
Month Day Year / d- i -I -V CZ.'41 nrl 2 W, Inchn School Rc!,, Ato 1f41
Vacc. Serial {Lot) No. Phoenix, AZ 05033
A-,1.,2,11;.-, ,u,r/A
VAC0410001
kemia tested Stray (past or present)
11.111
Has your pet ever been vaccinated? 0 Yes LI No If Yes, in which month of this past year? Has it been over 1 year? U Yes Li No
Check those which apply Dog: U Parvo/Distemper combo U Bordetella U Rabies (MoNear)
Cat: Di FVRCP Li Feline Leukemia U FIR U Rabies (MoNear)
1 hereby authorize the following: 0 SPAY (Female) U NEUTER (Male) U Declaw You are to use all reasonable precautions against injury, escape.
or death of my pet, but you will not be held liable or responsible
in any manner in connection therewith as it is thoroughly under-
l0 Dental U Nail Trim LI Ear Mite Treatment i0 Vaccinations stood that I assume all , risks, I am aware that you are not a 24
,hour care. facility
0 Pain Med. ID Lab U Other .
113 CC9 BM CP 11- FT 1E 0_ E Signature of Legal Owner or Authorized Person
s: ri BAR LI OTHER ,)
Service $
0: VVNL (Shc: EL O\ Spay/Neut $
L.,1 .4% E:1,- TNT Declaw $
VAC
Nail Tim $
Dental $
Heat/Preg $
Recovery Status .
Weight , .Temp . '` IP R / P R Cryotorchd$
- .1 f y i • .} Meds $
Vaccinations Given ., .
Ear mite Tx $
Medication Given:
Lab $
Rx -
Veterinarian Signature:
Coupons (-)$
Booster Vacs needed 43 Weeks ,dAnnual Vacs in 1 year U Return for suture removal (10-1
U Return in 6 mo. refill heartworm med. Testing: FELV F1V Headworm TOTAL
e,nn rrr rr r-s rtalr r, rm=ki r'rtr., fr ne -r inconDne

RABIES VACCINATION CERTIFICATE Tag fee $:
ADAPTED NASPHV FORM 51 Tag 41:
Owner's Name & Address - , PRINT - use ball point pen or type Cert. Serial it:
PRINT LAST FIRST, MI .. TELEPHONE
. . , , U2 3
..
NO. , STREET CITY STATE ZIP ..„..
H " / 1 r , ... ( I ( ) f )( i('
SPECIES: SEX: AGE: SIZE: . PREDOMINANT BREED: COLORS:
Dog Ll Male 0 3 Mo. to 12 Mo„:".1, Under 20 lbs. I), ( .1 l,. -
k.. ( li y. —I Ci
Cat El Female 0 12 Mo. or older b. 20 -50 lbs 0
Other El Altered n Over 50 lbs. 0 NAME:
(Specify) ,
DATE VACCINATED: PRODUCER: Veterinarian's # '
License No.
,
Month Day Year (First 3 Letters) Veterina 1",
1 yr. Lic.Naccp .0 .1 4(9Mig 114.06r1111 .'' .. , A? .
VACCINATION EXPIRES: SPA?
3 yr. Lic.Nacc. 0 73ataJndian School Rd., Ste 1P
1 Z 1 7 LI ()V ti Phoenix, AZ 85033
Month D ay Year 623-846-3979
Vacc. Serial (Lot) No.
VAC0410001
RABIES VACCINATION CERTIFICATE Tag fee $:
ADAPTED NASPHV FORM 51 Tag ii:
PRINT - use ball point pen or type CereSonaf it`.`..
Owner's Name & Address
PRINT LAST .a.RST... . MI TELEPHONE
/-7- 1 1 -/ - 1 i 1- t I
NO. -, STREET CITY .. STATE ZIP
)0
SPECIES: SEX: AGE: SIZE: PFIEDOMINANT BREED: COLORS:
Dog 0( Male ( 'cij 3 Mo. to 12 Mo. 0, Under 20 lbs. n; (,_ H \ ,x, __! r v
Cat 0 ' Female G 12 Mo. or older ..7'. 20 - 50 Ilas 0
Other 0 Altered L 1 Over 50 lbs. a NAME:
(Specify)
DATE VACCINATED: PRODUCER: Veterinarian's # . I l i
License No.
. / e, WI
Month Day Year (First 3 Letters) Veterin
1 yr. Lic.Nacc. C] §igilWr.6 PO H.,:' 1 :: :AFTER CLINIC
VACCINATION EXPIRES:
3 yr. Lic.Nacc. LI Al,s1N. Indian School Rd., Ste 108
) .2.- u-L.,' LP. t_( I AZ 85033 .
Month Day Year —823=846:3979-
Vacc. Serial (Lot) No.
–
VAC0410001

RABIES VACCINATION CERTIFICATE Rabies Tag Number
NASPHV Form #50
Print.; use ball,potnt pen or
Colors:
Under 20 lbs. El
20-50 lbs.
Over 50 lbs. "01)
Producer. 1 yr. Uc./Vacc.
3 yr. Lic./Vacc. azn-
For Licensing Agency Use
License No. Year
Month Day Year
Signature
atter VACCINATION EXPIRES: SPAY AND NEUTER GUC
Change 0 Acid 0 7242W. Indian School Rd., Ste 108
Control No. IC) Phoenix, AZ 85033
Month Day Year 823-8454979
RABIES VACCINATION CERTIFICATE Rabies Tag Number
NASPHV Form #50
Owner's Name..& Address Print - use ball point pen or type
PRINT - Last 1 tt"9_1_
VE'NIP\6(
)s) r L-..
Species: : Sex; LTX Age: Sze: I Predominant Breed: I Colors:
Dog Male U 3 mo. to 12 mo. Under 20 lbs. Al
Cal U atmaA 14 12 mo. or eldor 20-50 lbs. 'V
Memo Over 50 lbs. U n
Producer: 7-1c) le 1 yr. LicJVacc.
(First 3 Weis) 3 yr. Lic./Vacc. Oiher
For Licensing Agency Use DATE VACCINATED:
License No. Year \
10
Month Day Year
Other VACCINATION EXPIRES: SPAY ANOWLUTER CUMC
Change LI Add LI )( 7342W. Indian School Rd., Ste 18
Control No. .) 19 Phoenix, AZ 88033
Month Day Year 623-846-3979
en:60 91. 2Z 100

'
RABIES VACCINATION CERTIFICATE _,..., ,Tag fee $:
ADAPTED NASPHV FORM 51 "rabli:
Owner's Name & Address - '- PRINT - use ball point pen or type Cert. Serial 44:
PRINT LAST FIRST . MI TELEPHONE
y( y" i 1 I 1 .i 'L ( 1 . /'.:, ,:, 1 1. 2 '
NO. - STREET CITY ,. STATE ZIP
")
i ‘( ) 1 )4 I ;
SPECIES: SEX: AGE: SIZE: PREDOMINANT BREED: COLORS: .-
Dog 0,, Male 0 3 Mo. to 12 mo. CI Under 20 lbs. 0
Cat 0 Female 0 12 Mo. or older Cl; 20- 50 lbs ' 6 0 i n , , X,
Other 0 Altered 0, f . Over 50 lbs. III NAME: ,
(Specify) .
DATE VACCINATED: PRODUCER: Veterinarian's # ) ,,,
s1,iñ No 1\y
Month Day Year , (First 3 Letters) Veterinar n s
1 yr. Lic.Nacc. L Signature
VACCINATION EXPIRES: dSPAY AND NEUTER CLINIC
3 yr. Lic.Nacc. E Ad
I .) ,; I 1 , ,,.: ,,_,, TR2 VV. Indian School Rd., Sw it'll
Month Day Year I' • a . • t i
Vacc. Serial (Lot) No. f.-1-J.341.0,6-3'379
VAC0410001
-riAB-IgS VACCINATION CERTIFICATE Tag fee $: .
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name & Address PRINT - use ball point pen or type , :,,,, Cert. --,.„ Serial #:
PRINT LAST FIRST MI TELEPHONE
1 , , 1 ; i
H - '; • : '-.
NO. STREET CITY , STATE ZIP.
' ' '',. / j
SPECIES: SEX: AGE: SIZE: PREDOMINANT BREED: COLORS:
Dog LI , Male 0 3 Mo. to 12 Mo. ,,0 .Under 20 lbs. 4 0 11,) 1 ,x, 1 Ac(c
Cat 0 Female 0 12 Mo. or older D _20 - 50 lbs El (4(-
Other 0 Altered 0 Over 50 lbs. 111 NAME:
(Specify) 10 .. .. ...
DATE VACCINATED: PRODUCER: Veterinarian's #
License No.
Month Day Year (First 3 Letters) 1 , 441,1141 1 tv ., ' /. „ 14i7)7
1 yr. Lic.Nacc. illi SPX .i.t.." ,U 'NEUTER C u6::: '
VACCINATION EXPIRES: 12iWlcUil 'ouul Rd., SW —.
3 yr. Lic.Nacc. CI , AddresPhconix, A7 RnD33
1 . ,' I _ . ! ICI i (.,,/' G23-846-3979
Month Day Year
Vacc. Serial (Lot) No. ,
VAC0410001

RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (revised 2007)
RABIES TAG #
Owner's Name & Address Print Clearly MICROCHIP #
LAST FIRST M.!, TELEPHONE #
Hamel Judy (623) 810-1622
NO. STREET CITY STATE ZIP
12613 S. 189th Ave Buckeye AZ 85326
SPECIES AGE SIZE PREDOMINENT BREED PREDOMINANT
Dog IXI 2 Months0 Under 20 lbs.1 COLORS/MARKINGS
Cat 0 Years X 20 - 50 lbs. 1-.-X—} American Pit Bull Terrier
Ferret SEX Male Over 50 lbs. I I White with Tan
Other: 0 X Female ANIMAL NAME Spots .
(specify) r--7 Neutered
Animal Control License 171 Yr 1-73 Yr 1----- Other °rnpnlh's Alicia
DATE VACCINATED Product Name: Veterinarian's Name:
02/22/15 Rabies Evelyn Kass-Williamson, D.V.M.
Manufacturer:
Month) Day / Year (First 3 letters) B o e , License Number:
Xil Yr USDA Licensed Vaccine '-' ',L.-- 1,- c,— Z .-C---- 6 (_,) A.....-----__ 1___
NEXT VACCINATION D3 Yr USDA Licensed Vaccine Veterrnarian's Signature
DUE BY: 4 Yr USDA Licensed Vaccine Address: Fe Urgent Care
02/22116 5223 N. Dysart Rd.
Initial dose X Booster dose Edg, C
Month / Day / Year 1215396A Lrtchfiefd Park, AZ 85340
Vaccine Serial (lot) Number (623) 536-1600

RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (revised 2007)
RABIES TAG #
Owner's Name & Address Print Clearly MICROCHIP #
LAST FIRST MI TELEPHONE #
Hamel Judy (623) 810-1622 -
NO. STREET CITY STATE ZIP
12613 S. 189th Ave Buckeye AZ 85326
SPECIES AGE SIZE PREDOMINENT BREED PREDOMINANT
Dog X 5 Months Under 20 lbs.0 COLORS/MARKINGS
Cat E Years X 20 - 50 lbs. X Labrador Retriever
Ferret • SEX r Male Over 50 lbs. E Tan and White
Other: , X Female ANIMAL NAME
(specify) ..ife'-' I X I Neutered Daisy •
Animal Control License Fo Yr I-13 Yr [— Other a months
DATE VACCINATED Product Name: Veterinarian's Name:
02/22/15 Rabies Evelyn Kass-Williamson, D.V.M.
Manufacturer: ,
Month / Day / Year (First 3 letters) B 0 e License Number
( 1 t,
X 1 Yr USDA Licensed Vaccine 'C'..?--4- c• –.D.--10,---- '—
NEXT VACCINATION 3 Yr USDA Licensed Vaccine Veterindan's Signature
DUE BY: 14 Yr USDA Licensed Vaccine Address: Pet Urgent Care
02/22116 5220 N. Dysart Rd.
Initial dose 1 X Booster dose Bldg. C
Month / Day! Year 1215396A Litchfield Park, AZ 85340 .
Vaccine Serial (lot) Number (623) 536-1600

North Star Animal Hospital at Estrella Client No. 997
9860 S. Estrella Pkwy, Suite B115 Faithful, Forever
PO BOX 7753
Goodyear, AZ 85338 Avondale-Goodyear, AZ 85338
Phone: (623) 225-7387 Phone: (623)
Fax: (623) 218-6713
northstarestrella@gmail.com
northstarah.com
Rabies Vaccination Certificate
NAME: Taco
SPECIES: Canine WEIGHT: 0.00 lbs Rabies Tag #: 355
BREED: Beagle Mixed ID #1:
GENDER: MN .41p #2:
COLOR: Tr-Color -Last Visit: 1012012015
BIRTHDAY: 10/20/2005
AGE: 10 yrs, 0 months
Item Description Given Due Date Lot4 # Manufacturer Exp. Date
2007 RABIES CANINE - 3 YEAR 10/20/2015 10/14/2018 1215404A BI 7/16/2017
hei
I r by certify that this animal has been vaccinated in accordance with the manufacturer's recommendation for the vaccine used on above date.
.4:004- x9,4"-J.ticlptist
Date Issued 1012012015
Scott Duston, DVM License: 3854

Sun Valley Hope Animal Hospital
0 7150 North 110th Avenue
z 0 Glendale, AZ 85307
(623) 512-4673
Rabies Certificate
Patient ID: 17802
Client ID: 189 Patient Name: Aza
Client Name: Furry Smiles Rescue Specie; Canine
Address: 7508 W. India°la Breed: Chihuahua
Sex: Spayed Female
Phoenix, AZ 85033 Color: Brown
Phone: (714)788-1721 Marking 3:
Birthda!/: ,I 01/03/2014
Weight:
Tag Number: 00000000000000000000 Vaccination Date 1/10/201511
Lot Number: S406518 Expiration Date: 1/10/20161 •
Rabies Canine 1 Year Booster Vaccination
Producer: Pfizer
K / MLV / R: Killed Virus
Staff Name: Dr. Joshua Winston
License Number:
I Dose
Canine Adenovirus Distemper- Type 2-
Parainfluenza- Parvovirus Vaccine
Modieed live Vitus
Du ram une• Max 5
see co mpleie oiler dIcesOons, pa clop ex
Censoftss Slore Ann I a cola. PC.
BoehrlogesIngelhelm Velmedica, Ins.
1155,11. loseph. Lfe.No. 1+10.56506
916968A
4 DEG 15
150704-00

. RABIES VACCINATION CERTIFICATE Tag fee $: .
.
, .., . ,. .... - ADAPTED NASPHV FORM 51 Tag #:
Owner's Name& Address . -' PRINT - use ball point pen or type Cert. Serial #: - -'. ' •
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PRINT I:AST . ' i ,.F.IRST MI TELEPHONE
.
1- 1 i (Ylt 1 I I i ilk i ii 'I1A If.- 11 Vel. i-,71 i • . fi 11 i ,. f I.; ...- 3 r?-< 1 CI i ( /I 2-2-
NO. ' ' . .STFIET — . ' ' 7 CITY STATE ZIP
SPECIES: SEX: AGE: SIZE: PREDOMINANT BREED: COLORS:
Dog‘y Male \D \,,,1_, 3 Mo. to 12 Mo. 0 Under 20 lbs. Lil
Cat I] Female Li 12 Mo. or older CARO - 50 lbs — n a-) 1 A V-e 6/1 H-(0 --- i Li J
Other i Altered l',0' Over 50 lbs. \9,, NAME:
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1--"C.; 1-T h
DATE VACCINATED: PRODUCER: •
. - Vetetinarian'a_ ___< -1 )( 1 i
4Pir r ense p. 0./ -- ..'
Month Day Year /1
(First 3 Letters)
Veterinary - ",44 .• ..
VACCINATION EXPIRES: 1 yr. Lic.Nacc.'a - . Signature ' / -- •
3 yr. LiciVacc. D Addre y SPAY 4_ i 4. AND n. a NEUTER CLINIC
'. --; .1 S i e‘ ' _ .. . , _
Month Day Year qi ich4
Vacc. Serial (LOB No. PI,oeniir, t•7 8COnq
6-..::• r..I,,,,,64r-ic .
VAC0410001
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ADAPTED NASPHV FORM 51 Tag #:
Owner's Name & Address PRINT- use ball point pen or type Cert. Serial 44:
PRINT FIRST,-- , MI TELEPHONE
oTt k I e 17 -f a tTh-f;A, 1 O I
O0
NO. ,p 2i STR CiTYci STATE
ZIP 8. .... ,__, (....?
EB U OX. .1 -1S ---/ 0 OrlYe a r an tb
SPEC ES: SEX: AGE: SIZE: PREDOMINANT BREED: COLORS:
Dog Male in 3 Mo. to 12 Mo. 0 Under 20 lbs. d D xtc x
Cat El Female 12 Mo. or older i 20 - 50 lbs D
Other 0 Altered Over 50 lbs. D NAME:
(Specify)
45E VACCINATED: PRODUCER:
b J,)._ iS--- g e_ Veterinarian's #
License No.
Month Day Year .
(First 3 Letters)
Veterinarian's r.
1 yr. Lic.Nacc.
V.CINATION EXIT:, Signature .
I 3 yr. Lic.Nacc. n 1 s--14.6g4.
Address., : . .,, : .,..:„: L:Lu.,..11c;
Month Day Year 7:1,., ::: ',.,;r 5 r Si, -:: :-., . r -1
Vac. Serial (Lot) No. • , . - .
P t it ...`I!,...:1 -,' i.q.503
VAC0410001

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ADAPTED 1VASPHV FORM 51 Tag #:
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PRINV 11 t'Ac.,>- FIRST \ k Int \ i
A ,N..._.... k. • ...... ) k.._...)‘_' _ \ \ -)
NO. -). \i, f-s rd ) z STATE — 1/4•„••.
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SPEAS; SEX: AGE: SIZE: PREDOMINANT BREED: COLORS:
Dog *-"k•-) Male Ii'l.:: 3 Mo. to 12 Mo. ...= Under 20 lbs. 1- 4 -Z....A. ?ill
Cal 7 Female 17 12 Mo. or older 17,1 20 - 50 lbs L..: - _---\--1 ..
Other :...L. Altereds.„(2.1) Over 50 lbs. '1•7:. NAM.:
(Specify) ri
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DATE VACCINATED: • — . PRODUCER:
Veterinarian's II \ 1/4.-- --- ...--•••
.•-•• ' .:: Nit- License No.
Month Day Year
(First 3 Letters1
Veterinarian's
V_).CCINAITION EXPIRES: 1 yr. Lic - NaCCV ,, , Signature '-"--
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,....0 - \ 3 yr Lic Nacc r7
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Month Day Year ( J-.-',1. X....4 — .1 (:-..\-..1N / TC-::--
Vacc. Serial (Lot) No. -t';' 1,1/ l'•!••.'.!;•'. S-.'...:•::;:t.ii Rd., ;Ai,: iii-co ---
Pfloiiilk .... ,. ; . A;;: .. 83.(03
VAC0410001
RABIES VACCINATION CERTIFICATE Tag fee $:
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PRINT1LAST FOIST , MI TELEPHONE •
1-ie-kri‘Q_ -A V,6t. Li FOIre, ve r FC(*Cilirli 1 1..12:3 S IC) t LO 22,
NO. STRE EL CITY 1 STATE ZIP
PO /30<, -775 (TIC 0 Ci, e 0 v
SPECIrt SEX: AGE: S S-
SIZE: PREDOMINANT BREED: COLORS:
Dog Male fl _ 3 Mo. t o 1 2 Mo. 0 Under 20 lbs. 0
Cat 0 Female _ 12 Mo. or older \ILI: 20 -50 lbs y COLO \_k_\ ),(,, hi-
Other 0 Altered Llj . Over 50 lbs. 00AME:
(Specify) rg .
k-.. 0 (_ 6
DATE VACCINATED: PRODUCER: `4,-. •
c-7. Veterinarian's # V Lt: F-;--S-
Vic 13 i) -C License No.
Month Day Year
(First 3 Letters)
Veterinarians. ", ',, •:•-1) .:',! .1,-...tr-t, tt.:i.,1;..1t... ,
VACCINATION EXPIRES: 1 yr. . Lic.Nacc. re 7::)42. ;. pi itheo": eI:. •. i :._-?:•-plieli:vit to in
r--- ,, i r 3 yr. Lic.Nacc. 0 .
.' I . 4, Address G23 3A..--A 751
Month _ • Day Year 2-t ci-laq:1-
Vacc. Serial (Lot) No.
VAC0410001

-
RABIES VACCINATION CERTIFICATE Tag fee $: •
„
. ADAPTED NASPHV FORM 51 ga-a ft...7.„."
Owner's Name &Address -. PRINT - use ball point pen or type ' Cert.. .ertai ft:
PRINT LAST. i • '., FsIFIST ;-, . - MI , . TELEPHONE .
. 44-47 " 2 i - thr.- —I'. "/ (i l • ,. /- ,._ ' ) ' _. . , . 1 e; . i f t? 2 __
NO .1,-' , "STRE - .72...7 (-.re-'2 „ I Cnyi -` ,' f . - -1- STATE ZIP
• / - ' e .V
SPECIES: SEX: AGE: . 'SIZE: PREDOMINANT BREED: COLORS: .,e-A
Dog „Er Male . p 3 Mo. to 12 mo. D Under 20 lbs.0 , / 2 7 I 1
Cat 0 Female 0 12 Mo. or older IV , 20 - 50 lbs 0 (.- • • i- j ' / l f i'i ' tAr : r e I.Z-r IA 1,14 e f t 4- , ,--L. 1 ' !./..--:'
Other 0 Altered ''EI' Over 50 lbs. 0 NAME:
/ .
(Specify) . . .
DATE VACCINATED: PRODUCER: . I V.-C_Z_, •
.. . Veterinarlan's # '----f' (1 -----''
7.2 . • License No.
... ,---' ' • if9;
Month Day Year (Fist 3 Letters)
Veterinarian's
1 yr. Lic.Nacc. Cl' ' Signature
VACCINATION EXPIRES:
S yr. Lic.Nacn. 0 . ' Address :'''',-Al AND NEI iTFR. CO INIC
/7, 4 ., f . r ,
Month Day Year 7342 VV. Indian SchooiRd., Ste 108
' Vacc. Serial (Lot) No. - . Phoenix, AZ 85833 '
623-846-3979
rAC0410001
RABIES VACCINATION CERTIFICATE
Tag fee $:
ADAPTED NASPHV FORM 51 Tag II:
Owner's Name &Address PRINT - use ball point pen or type Cert. Serial #:
PRINT FIFrasIth
MI
Tr6jEt
LN°P6 cay 6. 0 ocl e v 47_
ETb)C STATE
SEX: AGE: ZIP 833
Dog Male SIZE: PREDOMINANT BREED: COLORS:
3 Mo. to 12 Mo. 0 Under 20 lbs. 0
Cat Female . 12 Mo. or older 20 - 50 lbs Li
Other 0 Alterecf
Over 50 lbs. \J0 NAME:
(Shecify) -fa n
DIF VACCINATED: PRODUCER: V
1
1 Veterinarian's # I
Month Day Year License No.
(First 3 Letters)
Veterinarian's
VACCINATION EXPIRES: 1 yr. Lic.Nacc. a_,
Signature — !(-4-4--'1'-'''`.---------
ft.0 3 yr. Lic.Nacc.
)a) Address_ • ._ I ii.:',!1:: ...;ir:tiTER ,r, CLINIC
Month Day Year sWEA 1 :6•,::4 W. W Indi an ,, thoel
Vacc. Serial (Lot) No. Phoafa, Rd., Ste 108
AZ 861733
VAC0410001 623-646-3979

. ,
RABIES VACCINATION CERTIFICATE Tag fee $:
- ADAPTED NASPHV FORM 51 Tag 4:
Owner's Name &Address - . PRINt- use ball point pen or type _Cert: -Senal-#:
,.. ; \
PRINT LAST. `,. FIRST : - : ;_. MI ;TELlaiONE
4 ()V V ( V ,T(,.p.. ,-;;1 1:-1"-=,..l t . LVZ A LL) 1W12 .
NO, S-TEET CITY 4--- . . STATE ZIP - •
1) 0 X - -1) S7.1 :7___) - (- -I bo(1%-i{-, ca7 . qs S IS -
. spEal S: SEX: • AGE: . SIZE: PREDOMINANT BREED: COLORS:
Dog I , Male D 3 Mo, to 12 Mo. El Under 20 lbs\.,17( r • . ._..i.. ., , .
Oat .1fi Female 1.2 Mo. or older 20- 50 ibs th -'n '?,-' ; ;_ i •---,
Other 0 Altered U Over 50 lbs. 0 NAME
RI (-4 c 1 4—
(Specify)
DATE VACCINATED 7 PRODUCER: Veterinarian's # 1.) Ge '1 ,
'-:-,,
...
Month Day Year (First 3 Letters)
Veterin nan's
1 yr. bell/no:IR - • Signature
VACCINATION EXPIRES:
3 yr. LIc.Nacc. 0 . AddiSRAY AND NEHTFR (".A plir:
I --) i (-7.- /.. / 3 I Fl
Month Day Year 7342.1111. Indian School Rd., i-Y.
Vacc. Serial (Lot) No. PilDerilX, AZ 8803:`
/AC0410001
RABIES VACCINATION CERTIFICATE Tag fee $: • .
"Tagrifi.
ADAPTED NASPHV FORM 51
,..z. . c-r-Cert. rial #:
_ :..„ . PRINTc=use ball point pen or type
Ovvner's Name & Address
MI • TELEPHONE
PRINT LAST FIRST . i ,c! I (1 / 6 ;....
/ CITY STATE ZIP ,
NO. STREET ,--, MT_
775- ? &.--,e),--i cr Ve --r
SEX:, . AGE: SIZE. PREDOMINANT BREED: COLORS:
SPECIES:
Dog rj", Malela .3 Mo. to 12 Mo' •-% 0 Under 20 lbs.10% ./-1 i / eih v Ct 1 .7:1 , --7
b Female b 12 Mo. or older p 20 -50 lbs /1-1 - L., • ' "
Cat Over 50 lbs, 0 NAME
Other 0 Altered 0
(Specify)
DATE VACCINATED: PRODUCER: Veterinarian's i t
... ,, License No.
Month Day (First 3 Letters) Veterinarian's cit... gx..,.. 4.----
. ,
1 yr Lic.Naca:UP Signature
VACCINATION EXPIRES: 6
3 yr. Lic.Nacc. Address
1:--) 13- Vc-v -' ' :" iillb"' 4e ND OEUTER CLINIC
ivl on h Day Year Vacc. Serial (Lot) No. 7342 W. Indian Schub! Rd., Ste 108
Phoenti, AZ 8oU33
VAC0410001 623-846-3979

RABIES VACCINATION CERTIFICATE Tag fee $:
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name &Addrss. PRINT - use ball point pen or type Cert. Serial #:
PRINT LAST i \ FIRST MI, .r..., ,..--_, TELEPHONE
• 11cM) .11 . k I„,.. \ ‘ ,.-- WI ..,.-e l t , ..kP:L-.5 r A 0
NO. STFLET . ' ..-- , 2. 1 civ i _ _. i STATE ill: .
_ il i ru 1 P( I V*
SPECIES: SEX : AGE: SIZE: .-- . ...- - 'PREDOMINANT BREED: COLC-ilS:-' - -
Dog i.. Male 0 3 Mo. to 12 Mo. 0 Under 20 lbs. 0 f.a... "-/--- - I A V
Cat 0 Female , 12 Mo. or older k,k 20-. 50 lbg o 1 1 't 1. )1 k A
Other 0 Altered p Over 50 lbs. `-ci NAME:
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(Specify) ' . - VI
DATE VACCINATED: PRODUCER: Veterinarian's # ( • -I lit 62, C:.
..- P , Licenie N' `---".
-
Month Day Year Orst 3 Letters)
Veterinarian's
1 yr. Lic.Nacc. a. 6 ,.
VACCINATION EXPIRES: S igna ture . A4-4-C 1
3 yr. Lic.Nacc.171 - . . Address
Month Day Year
Vacc. Serial (Lot) No. Lir AND iiELJTk CLINIC
• /.•,42 W. Indian School Rd Ste 1011
'AC0410001 Phoenix, AZ 85033
63-846-3979
RABIES VACCINATION CERTIFICATE Tag fee $:
- ADAPTED NAS PHV FORM 51 -- Tag #: r •
• - uso ban point pen or type 'Cert. SL'41-44t:, -
. Owners Name &Address
PRINrLAST FIRST . MI TELEPHONE ..
C 6; ?P17 / 6 ? 2-
1 STREET CITY STATE ZIP
ii;r1 7 Y"-
SPECIES' SEX: AGE: SIZE: PREDOMINANT BREED; COLORS:
Dog /.20''' Male 3 Mo. to 12 Mo. 0 Under 20 lbs. -1-124
Cat 0 Female 12 Mo. dr older 'Q.. 20 - 50 lbs 0
Other 0 Altered Over 50 lbs. NAME:
(Specify)
DATE VACCINATED: PRODUCER: Veterinarian's # -
License No.
Month Day Year .(FIrst 3 Letters) Veterinarian's
1 yr. LicRacc. Signature
VACCINATION EXPIRES: Ark,s1:1) GLIMG
3 yr. Lic.Nacc. Address
6.ohoo1Rdi, Ste.108
Month Day Year / i (•-• Phoenix, AZ 85033
Vacc. Serial (Lot) No : 623-846-3979
VAC0410001

• RABIES VACCINATION CERTIFICATE • Tag fee $:
ADAPTED NASPHV FORM 51 - Tag it' • . ..
Owner's Name & Address PRINT - uSo ball point pen or type ..,,, Cart.,Serial #:
PRINT LAST l -/,,., .. i FIRST - : .__ t / ; , ,, . j MI TELEPHONE ,
' /1-(i. fri'lL.2 1 (1/ 1/6•7 <I . IC ',/--: '7 ?/ e) I 672
14(:). PI ,...-STREET,..... . , ST T.E, • Ziii r:--,-- „: • _
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SPECIES: ., . --- SEX:'' ' ,SIZE.- : .?: • , PREDOMINANT BREED: COLORS: 1 /
Dog 0' Male • 1:11 , 3 Mo. to 12 Mo. 0 Under 20 lbs.. 0 0 1/101 i ? - i -I i;:.:,=-. .
Cat 0 Female 0 12 Mo. or older,.. lg-120 -50 Ihs 0
Other 0 Altered 0 ' - Over 50 lbs. LI NAME: ::•:1 '17<?
/
(Specify)
. .-.
DATE VACCINATED: PRODUCER: Veterinarian's #
• License No., .
I? 0
Month Day Year (FliSt 3 Letters) Veterinarian's
(t, 6 •
1 yr. Lic.Nacc fla • Signa t ure )
VACCINATION EXPIRES: .
3 yr. Licpacc.0 _ Address .':..N: AND NEUTER CLINIC
-- -10----i:
Month Day Year 7842 91. Indian School -Rd.,-Ste 108 •-
Vacc. Serial (Lot) No. Phoenix, AZ. 8503 !
A9Z-R44..107q
IAC041 0001
I.
RABIES VACCINATION CERTIFICATE t•-)ralfee $:
. ADAPTED NASPHV FORM 51 Tag #: .
Owner's Name &Address f.-.t—''::' ,'IMINT - uke.pall point pe- i or type . Cert. Serial ft:
. . ... .
PRINT LAST / . ' ,• Finarj ' Ml TELEPHONE
l'It?,1?/) fl / ._, /1 /1(11/ _. ... i -11-1 , .g/ (,) i/ 2.- 2
. NO. . ' ,_ STFtEkT; .. - . ----: --,-: 0•-•"--r`: --r -CITY t . • --- . STATE/ .., • ZIP ,,..... -
/ / '''' -- L )1) f?',, e-,,, (0(z 7– T''',:
SPECIES: SEX: . AGE: - SIZE: / . - PREDOMINANT BREED: - COLORSh •
Dog -Ng; Male ":,j7P '3 Mo. to 12 Mo. 0 Under 20 lbs. ;11--n." , it? fp IT • /1 1.. . ; ,
4-- I j ••• i ( f • '''# i
Cat 0 Female . 0 12 Mo. or older ,...0 ..-• 20 - 50 lbs LI r . ' • ' -, - '- . - -
Other 0 Altered 0 .OVer 50 lbs. n NAME: . -- - • :
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DATE VACCINATED: PRODUCER: Vete rinarian's # . I i, lc '• , •
/7( Lice‘hge- Nor'• ---
:„,..
Month - ' bay Year (First , 3 Letters) .
Veterinarian's
- 1 yr. Lic.Nacc. 0 .__- • Signature V
VACCINATION EXPIRES: CI • . . 'll Afk1,0 .,--.1.;:5-ITER CLINIC
3 yr. Lic.Nacc. , .. , ., Address, ,.'
/ . .' :.I f' j r 74..- ,, ei,;'.., • /.-:•;.:. IN. Indian ot huol.RdSte 'IN — •
:-/ cd 1
Month Day Year Phonnix,,47 R5033
Vacc. Serial (Lot) No. • 623-846-3970
VAC0410001

RABIES VACCINATION CERTIFICATE - - Tag fee S:
• ADAPTED NASPHV FORM 51 --- • 17-Taa ..;
, -
Owner's Name &Address- PRINT - use ball point pen or type ' . Cert. Serial #:
_.
PRINT LAST ' FIRST MI . TELEPHONE , , - • ,
- r i 111 ,e- ,-, I • . - ) r i 1 --1 i - 1_.! / - - , , . 71's 1
l'" i iu--. .1, - i 1 '.- ..... ,' f, -/
NO. , - STREET - I CITri • STATE ti ...,7 ZIP ......
r ' . ) . . t - 1 l .e . i i - , - . . ' i - i' F -1. . r'z5jS
SPECIES: SIX: AGE: _ SIZE: r PREDOMINANT BREED: ; COLORS: 4/ . 1
Dog Male a / 3 Mo. to 12 Mo. 0 Under 20 lbs. 0 t 7 4 f;e:
Cat 0 Female 0 1 2 MO. Or Older : F1-"f2-tr="501-Er-----<4 ,' .. , j10,11 CO' '. : .' ' 'T
Other 0 Altered 0 ' Over 50 lbs. if15-- NAME: . i
,:
(Specify) t
DATE VACCINATED: PRODUCER: Veterinarian's # \'-._ 01:2`E--... •
rr- Licenbe-No. `----' --."
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Niiiiith Day Year (First a Letters ) . Veterinarian's CL. &A.,o..... 1.4...------
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• 1 yr. Lic./Vacc.0,-- "- • Signature
VACCINATION EXPIRES:
3 yr. Lic.Nacc. 0 - Address
t_ • —,14 .. it ,,i ACID NEUTER CLINIC
Month Day Year • i y 1- '--
Vacc. Serial (LoirNo. , I.-.:4 i=f1. iricitarr.:Lichool Rd. Ste lett
Phoenix, AZ 5O33
tAC0410001 S23-846-3979
RABIES VACCINATION CERTIFICATE Rabies Tag Number
NASPHV Form 050
Owner's Name & uer, Address Print - use bail mint Den or time
PHI ing.FirAt 10(1‘Ad
Cio TUrk 116 4
N . Street V.--- 16601 State Ziogs-3.-
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'-g S3
Species: ex: .,, i Age: Size: Predo Mani Brood: Colors:
Dog NIS..1 Male 1.1\ 3 mo. to 12 mo.0 Under 20 lbs,
u p 6-dr--- 3tr_
Cat Fe a ZI 12 mo. or older., 20-50 lbs.
Nam _ Over 50 lbs. 'a
y
i Vacc. Serial (lot) No.
Producer: a 1 yr. Lic.Nacc.
(First 3 letters) 01 3 yr. Lic.Nacc. Other St/ / 3 (Q(
For Licensing Ageney (Jae DATE VACCINATED: .-.7 Q
License No. Year r• .4.. Veterinarian's: # 37-i93
i 9 1--. License No.
Mot\€ Day Year ., r .11 ,, - n
, . •
'--Siertature
Other VACCINATION EXPIRES; „(if
i i - i
Change D Add U
Control No. iCi 1 ((.31 BPCEEYE VETERINARY SEM/IC
Month Day Year s 24090 W. HWY. CE5

RABIES VACCINATION CERTIFICATE Tag fee $:
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Owners Name &Addres8 PRINT - use bell point pen or type - Cert. Serial #:
PRINT LAST I. / : -i-eP"I'lti6"1":q, e . . . - :, - MI ,• ..., , TELEPHONE , . i-
-11-1 '','. / . .." ''.111(41 . _ . ''.15 i t , I 1.. ,./ (:,_
' .• . STREET , / ,..-..k i - - .....---; / .. 7 <,- .4- -. - ,1/1 ,,...... ,i„,,..-..... CITY- / 2 ,.,'; .." - /..... ;) ,-,-, ,• , STATE,--'; •k c .. ,„ ) - '.<1. ,/,'' . . •
. . . / f °,,. '4- , I - ! . . ..... -
SPEFIESJ, SEX: ' AGE: SIE: - PREDOMINANT BREED: COLORS: -
Dog! XI Male 0 3 Mo. to 12 Mo. 0 Under 20 lbs. 0 0/ ,
Cat ' 0 Female :El 12 Mo. or older 'kr. 20 - 50 lbs D 17 .. fr. '''''? - •-1 r .t.-L-1 yr' , • i.: 67 4- \i'y , • i •-• 1 1 - (i .- • - .. -.
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Other lj Altered 0 Over .50 lbs. q, „NAME: .
(Specify) . , '
..
DATE,VACCINATED: ' PRODUCER: -. ` •
....'" Veterinarian's #
, .._ : • .. ... License NO:--- - ?fi
,
Month Day Year . (Firsts Letters) _. .
- Veterinarian's
._ ' 1 yr. Lic./Vacc. 0.--- Signature (1,
V ,AQCINATION EXPIRES: . .
. 3 yr. Lic.A./acb. 0 ,/,..) /2-1,/ / / ,../i - Address ... - - - .
i:.,' j 5 , , Lif ,t'-4-
Month • Pay. • Year . . - . • . el:tic il.;''.11) ;',-1--..f fIr:-V Ci WIC
i Mace. Serial (Lot) No.
'1.342 iiLf. Indian School Rd., Stel108 -...,.' .
ri-r , • ttc.: A,' tlufil0 Arr... .) '
623-846-3979
RABIES VACCINATION CERTIFICATE Tag fee 3:
ADAPTED NASPHV FORM 51 Tag-#:
. C.erL•Serial #:
PRINT - use ball point pen or type
PRINT LAST " FIRST MI TELEPHONE
/II e 1 v CI y' 4 .i- 7 ..- 'JO / f:''' e?' ...--Q.,
9
NO. . , STREET ,PliY STATE „ ZIP
Pe•L' '.(9 -I- - - `.?( 77 ..,- 3
SPECIES: SEX: . AGE: . SIZE: PREDOMINANT BREED: COLORS:
Dog (PR Male 0 3 Mo. to 12 Mo. 0 Under 20 lbs . ,_-. li -:-\\I-V-' ,--5t. k,- im 1,__ ) ' ' i
'Cat 0 Female 12 Mo. or older ,,,ca 20 -50 ibs LI --'''''..4 - '
• .0 . Altered ''..... - Over 50 lbs, \ D NAME:
Other
•
(Specify)
' •
DATE VACCINATED: - PRODUCEIR : - Veterinarian's # 11 (-%
License 'Igo.
Month Day Year ::, {First 3 Letters) . Veterinarian's _
, -
1 yr. Lic.Nacc . Signature CrL.
VACCINATION EXPIRES:
3 yr. Lic.Nacc. Ell , . ' Address
1 —cif ,.. - ei SPAY AND NEUTER CLINIC
IA/ / ) t ,i'Y h
Month Day • Year V
Vacc:Serial (Lot) No. • • Phoenix, AZ 85033
I VAC0410001