Certificate of Veterinary Inspection · issued 2022-09-08
35-245708
RIDGLAN FARMS, INC. → IIT RESEARCH INSTITUTE · 16 dogs
Consignor (shipper)
RIDGLAN FARMS, INC.
10489 W. BLUE MOUNDS ROAD BLUE MOUNDS, WI 53517
Consignee (buyer)
STATE STREET DOCK 10 WEST 35TH STREET CHICAGO, IL 60616
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
Not returning to WI; Permit Number: IP003017; Owner mailing address: P.O. Box 318 Mt. Horeb, WI 53572; Email: ridglan@mhtc.net
Animals listed on this shipment (16)
| ID | Breed | Sex | Age / DOB | Color | Microchip / tattoo | Other |
|---|---|---|---|---|---|---|
| GYW-1 | Beagle | F | 7-10 Mos; Rabies Vaccination Date: 08/30/22; Rabies Exp. Date: 08/30/23; Product: Nobivac 1-Rabies; Serial: 538378; Rabies Tag: N/A; Other Vaccinations: Canine 1-DAPPv; Date Vaccinated: 07/13/22; Vaccine Producer: Nobivac | |||
| HKW-1 | Beagle | |||||
| KSW-1 | Beagle | |||||
| QWW-1 | Beagle | |||||
| QZW-1 | Beagle | |||||
| RCW-1 | Beagle | |||||
| SOW-1 | Beagle | Row 7 has checkmarks across all columns indicating data continuation from row 1 | Row 7 has checkmarks across all columns indicating data continuation from row 1 | |||
| WGC-2 | Beagle | F | 7-10 Mos; Rabies Vaccination Date: 08/30/22; Rabies Exp. Date: 08/30/23; Product: Nobivac 1-Rabies; Serial: 538378; Rabies Tag: N/A; Other Vaccinations: Canine 1-DAPPv; Date Vaccinated: 07/13/22; Vaccine Producer: Nobivac | |||
| DJX-1 | Beagle | M | ||||
| GUX-1 | Beagle | |||||
| HSX-1 | Beagle | |||||
| JBX-1 | Beagle | |||||
| JRX-1 | Beagle | |||||
| KXX-1 | Beagle | |||||
| LRX-1 | Beagle | |||||
| RIX-1 | Beagle | Row 15 has checkmarks across all columns indicating data continuation | Row 15 has checkmarks across all columns indicating data continuation |
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-15896138-1 · doc_class PaperCvi