Certificate of Veterinary Inspection · issued 2022-04-12
35-245648
RIDGLAN FARMS, INC. → UNIVERSITY OF ILLINOIS · 2 dogs
Consignor (shipper)
RIDGLAN FARMS, INC.
10489 W. BLUE MOUNDS ROAD BLUE MOUNDS, WI 53517
Carrier
Not stated on the certificate.
Issuing Veterinarian
Richard J. Van Domelen, D.V.M.
P.O. BOX 318 MT. HOREB, WI 53572
Remarks / additional certifications
Owner mailing address: P.O. Box 318 Mt. Horeb, WI 53572; Permit Number: 195281-WEB6658; Not returning to WI; Email: ridglan@mhtc.net
Animals listed on this shipment (2)
| ID | Breed | Sex | Age / DOB | Color | Microchip / tattoo | Other |
|---|---|---|---|---|---|---|
| FXS-9 | Beagle | F | Serial Number: 523628; Rabies Tag: N/A; Age: Adult; Rabies Vaccination Date: 03/25/22; Rabies Exp. Date: 03/25/23; Rabies Vaccine: Nobivac 1-Rabies; Other Vaccinations: Canine 1-DAPPv; Date Vaccinated: 03/25/22; Vaccine Producer: Nobivac | Serial Number: 523628; Rabies Tag: N/A; Age: Adult; Rabies Vaccination Date: 03/25/22; Rabies Exp. Date: 03/25/23; Rabies Vaccine: Nobivac 1-Rabies; Other Vaccinations: Canine 1-DAPPv; Date Vaccinated: 03/25/22; Vaccine Producer: Nobivac | ||
| RGO-9 | Beagle | Same vaccination details as FXS-9 (indicated by ditto marks) | Same vaccination details as FXS-9 (indicated by ditto marks) |
The CVI form lists each dog individually. Per-animal vaccination and treatment history is on the source PDF.
Primary source
This certificate was published by Wisconsin DATCP and is hosted on cvicentral.com. Click through to see the original PDF with all vaccination dates, treatment records, and any handwritten notes.
Extraction provenance
shrine_id BUNDLE-bac8be4d-1 · doc_class PaperCvi