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Certificate of Veterinary Inspection · issued 2024-06-20

35-265142

RIDGLAN FARMS, INC.NAMSA · 3 dogs

Open source PDF ↗

Consignor (shipper)

RIDGLAN FARMS, INC.

10489 W. BLUE MOUNDS ROAD BLUE MOUNDS, WI 53517

Phone
608-437-8670

Consignee (buyer)

NAMSA

8945 EVERGREEN BLVD MINNEAPOLIS, MN 55433

State
MN
Shipped
2024-06-20
Inspected
2024-06-20
Issued
2024-06-20
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 06/11/2024, expires 06/11/2025 (Nobivac 3-Rabies)
Other declarations
Veterinarian certifies animals have been inspected and are not showing any signs of infectious, contagious and/or communicable disease (except where noted). Vaccinations and test results are as indicated on this certificate.

Vaccinations (2)

NameManufacturer / ProductLotAdministeredExpiresApplies to
RabiesNobivac 3-Rabies6882142024-06-112025-06-11specific
Canine 1-DAPPvNobivac2024-05-10specific

Remarks / additional certifications

Owner/Agent: Pamela G. Burke. Owner mailing address: P.O. Box 318 Mt. Horeb, WI 53572. Not returning to WI.

Veterinarian certifies animals have been inspected and are not showing any signs of infectious, contagious and/or communicable disease (except where noted). Vaccinations and test results are as indicated on this certificate.

Emails on form: ridglan@mhtc.net

Animals listed on this shipment (3)

IDBreedSexAge / DOBColorMicrochip / tattooOther
IBY-3BeagleF6 Mos6 Mos
IUY-3BeagleF6 Mos6 Mos
HWZ-3BeagleM6 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 35-265142
Extraction provenance
Source modeltier2b · claude-sonnet-4-6 · prompt tier2b.dittoaware
Extracted2026-05-27 00:37:50
Tokensin 3395 · out 1848 · cost $0.0379
Overall confidence0.82 · cross-tier agreement 1.00
Model notesPage 1 of 1. Three Beagle dogs listed. Row 1 (IBY-3) has explicit values for Sex=F, Age=6 Mos, Rabies vaccination date 06/11/24, expiry 06/11/25, product Nobivac 3-Rabies, serial 688214, Rabies Tag N/A, Other Vaccination Canine 1-DAPPv dated 05/10/24, producer Nobivac. Rows 2 (IUY-3) and 3 (HWZ-3) show vertical ditto lines through Breed (BE), Age, Rabies Vaccination Date, Rabies Exp Date, Product/Vaccine Producer, Serial Number, Rabies Tag Number, Other Vaccinations, Date Vaccinated, and Product/Vaccine Producer columns — all inherited from row 1 per the ditto rule. Row 3 (HWZ-3) has an explicit Sex=M, breaking the ditto for that column. The rabies vaccination and Canine 1-DAPPv vaccination details are recorded only explicitly in row 1 but the ditto lines indicate they apply to all three animals; however, given the ambiguity about whether vaccination records fully extend via ditto to rows 2 and 3 (the lines are present but specific serial/tag fields are less clear), vaccinations are listed with applies_to='specific' for IBY-3 with a note. The owner mailing address differs from origin address (P.O. Box 318 Mt. Horeb vs. 10489 W. Blue Mounds Rd, Blue Mounds) — both appear to be Ridglan Farms contacts. Certificate received by WI on 24 Jun 2024.

shrine_id 936092 · doc_class PaperCvi