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Certificate of Veterinary Inspection · issued 2023-05-24

35-257433

Dawn Kundert → Molly Vesely · 1 dogs

Open source PDF ↗

Consignor (shipper)

Dawn Kundert

10141 Sharp RD Mt. Horeb WI 53572

Phone
(608) 201-6408

Consignee (buyer)

Molly Vesely

20445 Drewry RD Rochester WA 98579

State
WA
Phone
360-508-1720
Shipped
2023-05-25
Inspected
2023-05-23
Issued
2023-05-24
Purpose
Animals are traveling with owner on vacation
Species
Dog

Carrier

Not stated on the certificate.

Issuing Veterinarian

Jeff R. Kundert

Mt. Horeb Veterinary Hospital

1300 Springdale St, Mt. Horeb

Phone
608-437-8122
State license
404578
USDA accreditation
03090 1

Health declarations

Rabies
Rabies vaccination listed; expiration noted as 4 years; date listed as 'Too young'
Other declarations
Veterinarian certifies animal(s) have been inspected and are not showing signs of infectious, contagious and/or communicable disease.

Vaccinations (2)

NameManufacturer / ProductLotAdministeredExpiresApplies to
Rabiesspecific
Nobivac PuppyNobivac / Nobivac Puppy2023-05-23specific

Remarks / additional certifications

Animals are traveling with owner on vacation. Page 1 of 1. Received by WI Fri, 02 Jun 2023 11:59am CDT.

Veterinarian certifies animal(s) have been inspected and are not showing signs of infectious, contagious and/or communicable disease.

Emails on form: jkundert@mthoreb.myhospital.com

Animals listed on this shipment (1)

IDBreedSexAge / DOBColorMicrochip / tattooOther
956000016774616Belgian TervurenF4 yearsBrown w/ Black mask9560000167746164 years

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.

Open CVI 35-257433 ↗
Extraction provenance
Source modeltier2b · claude-sonnet-4-6 · prompt tier2b.dittoaware
Extracted2026-05-27 00:37:50
Tokensin 3395 · out 1439 · cost $0.0318
Overall confidence0.72 · cross-tier agreement 0.83
Model notesSingle animal on the form. The 'Rabies Vaccination Date' column appears to read 'Too' and the 'Rabies Exp. Date' reads 'young' — together this likely means the dog was 'Too young' for rabies vaccination at time of inspection, which is consistent with a puppy receiving Nobivac Puppy vaccine. The age column reads '4 years' but given the Nobivac Puppy product this may be misread; however the handwriting says 'G4u(k)s' which is interpreted as '4 years' (possibly 'G4 yrs' or similar). The 'Other Vaccinations' column reads 'DPt/Parvo' and the Product column reads 'Nobivac Puppy'. Microchip number is partially unclear — read as 956000016774616 but last few digits may differ (handwritten '956 000016 774 616' or '77 4616'). The vet email is partially illegible and represents a best-effort read. The issue date (DATE CVI ISSUED) reads 5/24/23 and inspection date (DATE INSPECTED) reads 5/23/23.

shrine_id 638112 · doc_class PaperCvi