Certificate of Veterinary Inspection · issued 2024-06-24
35-265143
RIDGLAN FARMS, INC. → WASHINGTON UNIVERSITY IN ST. LOUIS · 1 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
Health declarations
Vaccinations (2)
| Name | Manufacturer / Product | Lot | Administered | Expires | Applies to |
|---|---|---|---|---|---|
| Rabies | Nobivac / Nobivac 3-Rabies | 2024-06-20 | 2025-06-20 | specific | |
| Canine 1-DAPP | Nobivac / Nobivac | 2024-03-14 | specific |
Remarks / additional certifications
Owner/Agent: Pamela J. Burke. Owner mailing address: P.O. Box 318 Mt. Horeb, WI 53572. Not returning to WI. Number of animals in shipment: 1.
Veterinarian certifies animal(s) have been inspected and are not showing any signs of infectious, contagious and/or communicable disease (except where noted).
Emails on form: ridglan@mhtc.net
Animals listed on this shipment (1)
| ID | Breed | Sex | Age / DOB | Color | Microchip / tattoo | Other |
|---|---|---|---|---|---|---|
| HTX-3 | Beagle | M | 7 MO | 7 MO |
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 939488 · doc_class PaperCvi