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Certificate of Veterinary Inspection · issued 2024-05-21

35-265135

RIDGLAN FARMS, INC.TEXAS A & M UNIVERSITY · 6 dogs

Open source PDF ↗

Consignor (shipper)

RIDGLAN FARMS, INC.

10489 W. BLUE MOUNDS ROAD BLUE MOUNDS, WI 53517

Phone
608-437-8670

Consignee (buyer)

Texas A&M University

800 RAYMOND STOTZER PKWY COLLEGE STATION, TX 77843

State
TX
Shipped
2024-05-21
Inspected
2024-05-21
Issued
2024-05-21
Purpose
Species
Dog

Carrier

Not stated on the certificate.

Issuing Veterinarian

Richard J. Van Domelen, D.V.M.

P.O. BOX 318 MT. HOREB, WI 53572

Phone
608-437-8670
State license
4502
USDA accreditation
033491

Health declarations

Rabies
Vaccinated 05/15/2024; expires 05/15/2025 (Nobivac 3-Rabies, Serial 688214) — applies to GWW-3; remaining animals have no rabies vaccination data recorded
Other declarations
Veterinarian certifies animals are not showing signs of infectious, contagious and/or communicable disease (except where noted). Vaccinations and test results are as indicated on certificate. Animals meet state of destination and Federal interstate requirements.

Vaccinations (2)

NameManufacturer / ProductLotAdministeredExpiresApplies to
RabiesNobivac / Nobivac 3-Rabies6882142024-05-152025-05-15specific
Canine 1-DAPPNobivac / Nobivac2024-03-14specific

Remarks / additional certifications

Owner/Agent: Pamela J. Burke. Owner mailing address: P.O. Box 318 Mt. Horeb, WI 53572. Not returning to WI. Animals are not traveling with owner on vacation.

Veterinarian certifies animals are not showing signs of infectious, contagious and/or communicable disease (except where noted). Vaccinations and test results are as indicated on certificate. Animals meet state of destination and Federal interstate requirements.

Emails on form: ridglan@mhtc.net

Animals listed on this shipment (6)

IDBreedSexAge / DOBColorMicrochip / tattooOther
GWW-3BeagleF6 Mos6 Mos
RAW-3BeagleF6 Mos6 Mos
SRW-3BeagleF6 Mos6 Mos
TVW-3BeagleF6 Mos6 Mos
TZW-3BeagleF6 Mos6 Mos
XSW-3BeagleF6 Mos6 Mos

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 35-265135
Extraction provenance
Source modeltier2b · claude-sonnet-4-6 · prompt tier2b.dittoaware
Extracted2026-05-27 00:37:50
Tokensin 3395 · out 2220 · cost $0.0435
Overall confidence0.82 · cross-tier agreement 1.00
Model notesSingle page CVI. The ditto/vertical-line rule was applied to rows 2–6 (RAW-3 through XSW-3) for Breed (BE=Beagle), Sex (F), and Age (6 Mos), all inherited from row 1 (GWW-3). Row 6 (XSW-3) has explicit checkmark ticks terminating the ditto lines, confirming inheritance through all rows. Rabies vaccination data (date, expiry, product, serial) is explicitly entered only for GWW-3 in row 1; rows 2–6 have no rabies or other vaccination data recorded — it is unclear whether this is intentional (only GWW-3 was vaccinated) or an omission, so vaccinations are recorded only for GWW-3. The 'Canine 1-DAPP' / Nobivac entry in the Other Vaccinations column also appears only for row 1. Owner agent signature reads 'Pamela J. Burke' (best reading). Veterinarian license number read as 4502. National accreditation number 033491.

shrine_id 915438 · doc_class PaperCvi