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01-03-1996
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01-03-1996
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Last modified
7/31/2018 3:15:42 PM
Creation date
7/31/2018 7:17:55 AM
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MV City Council
City Council Document Type
City Council Packets
Date
1/3/1996
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4) Rabies Tag Number <br /> SYNBIOTICS-7-=-1 iiii <br /> Ai Rabies Vaccination <br /> , Certificate Please print-Use ball point pen 17P/3 ?.3 <br /> Owner's Last Name First Middle Initial Telephone <br /> Number Street v City State Zip <br /> E-- Y ."-c- gp,1 Oa Ar,_. <br /> 'if • ifilner/s: 1.1;ei.J.) r7) C) • '..37-5 // ....? <br /> Species: Sex: Age: Size: Name: Predominant Breed: Colors: <br /> :-. cg .-_-Male T 3 montris to 12 months 7:Under 20 lbs. day;le y 5ktrei <br /> 7_Cat 7k...Female '12 months or older .)-4-'20 to 50 lbs. Veterinarian's license Number: fq c..0 ri <br /> _—_Other _Neutered --f.Over 50 lbs. <br /> (Specify) <br /> Producer: Veterinarian's Signature: <br /> year License Vaccination <br /> Cir /-72 4'7 C e.:,..--77 6.••• r <br /> Owe Vaccinated: \-. I 't ' A 7.:3 year License Vaccination Address: / <br /> Mown 4; Day 199)-- (First 3 Letters) <br /> Vaccination Expires: Vaccination Senal(Lot)Number <br /> Day 217 .97 1 9 3& 5' 'L •/- <br /> i <br /> -"':-.17 :,'""1". 7;:79(7,, -:•-:•;.7!" <br /> -11 Je 3 <br /> 41111 <br /> • <br />
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