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• <br /> fa I .. ! Rabies Tag NumoerI A Rabies Vaccination SY"B'°T'C,__ ` <br /> CertificatePlease print-Use ball point pen )„5 Y 6 <br /> OwnersLast Name First Middle initial I Telephone <br /> C ressie';a (2),/an ;r. 7e6- S/6. V7 <br /> i Numoer Street City State i Zip <br /> �y . WO(i ( /. C r, fna z„z(is ,) g Lf ) VV11 . V./12 <br /> 1 Species: Sex: Age: Size: <br /> Name: Predominant Breed:. Colors: <br /> yyi <br /> -k Dog _ Male 3 montns to 12 months Under 20 lbs. Lyn dam' -how Ze �, <br /> ��'lllcccG <br /> _ Cat •Female J3-t 2 months or older Xf 20 to 50 lbs. Vetennanan's Li ense Number I <br /> i _Other J4 Neutered _-Over 50 lbs. I ( CG~'7"`�-.c ej <br /> (Specify) / <br /> 1 Producer: Veterinarian's Signature: <br /> f1 W.1year License Vaccination ',- -Cy-C�,,`A <br /> Date Vaccinated: I (../ ii:� ' � 3 year License Vaccination A dress: <br /> Month <br /> A- Day_,Z2_199:57 (First 3 Letters) <br /> Vaccination <br /> Expires: Vaccination SSehal(Lott Numoer/ <br /> Month___/—)...___Dan *of /'{ 19 i_L // 9.�G !er ./"1 I <br /> d f y/% /XYZ <br /> t_ X1 , <br /> • <br />