<<Organisation>>
RABIES VACCINATION CERTIFICATE
| ANIMAL: | OWNER: | |
| Animal ID: <<ShortShelterCode>> | Person ID: <<OwnerID>> | |
| Animal Name: <<AnimalName>> | <<OwnerName>> | |
| Species: <<SpeciesName>> | <<OwnerAddress>> | |
| Breed: <<BreedName>> | <<OwnerCity>>, <<OwnerState>> <<OwnerZipCode>> | |
| Coat Color: <<BaseColorName>> | ||
| Age: <<Age>> | <<MobileTelephone>> <<HomeTelephone>> <<WorkTelephone>> | |
| Birthdate: <<DateofBirth>> | ||
| Altered: <<Neutered>> | ||
MICROCHIP:
<<MicroChipNumber>>
| Certificate Number: | <<RabiesTag>> | |
| Vaccination Date: | <<VaccinationGivenRecentRabies>> | |
| Vaccination Expires: | <<VaccinationExpiresRecentRabies>> | |
| Manufacturer - Brand: | <<VaccinationManufacturerRecentRabies>> | |
| Lot Number - Lot Expires: | <<VaccinationBatchRecentRabies>> | |
| Live/Killed: | K | |
| Delivery Method: | Subcutaneous |
I certify that the above animal has been vaccinated against rabies.
_____________________________________________________
(Signature) <<VaccinationAdminsteringVetNameRecentRabies>>
License Number: <<VaccinationAdministeringVetLicenseRecentRabies>>
<<Date>>