VS 4-33A Brucellosis Test Record Continuation Sheet

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB number. The OMB control number for this information collection is 0579-0047. The time required to complete this collection of information is estimated to average .17 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

OMB Approved 0579-0047 Exp. 00/00/0000

UNITED STATES DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE VETERINARY SERVICES

BRUCELLOSIS TEST RECORD-CONTINUATION SHEET Complete all entries on VS Form 4-33 before using this form.

HERD NUMBER

PAGE NO.

HERD OWNER – LAST FIRST INITIAL

DATE BLED

VETERINARIAN

TUBE NO.

2

RECORD ALL IDENTIFICATION NUMBERS

VACC TATTOO

AGE

BREED

SEX

FLDT

LABORATORY RESULTS

TEST IN TERP.

REMARKS AND ADDITIONAL INFORMATION

REACTOR TAG NUMBER

RAP

FPA

CARD

RIV

CF

VS Form 4-33A Replaces edition date of (2/92), which may be used

APR 2009