VS 4-33A Brucellosis Test Record Continuation Sheet

Brucellosis Program

4-33A

Brucellosis Program - State

OMB: 0579-0047

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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

File Typeapplication/msword
File TitleAccording to the Paper work Reduction Act of 1995, no persons are required to respond to a collection of information unless it d
AuthorGovernment User
Last Modified ByKhbrown
File Modified2009-04-15
File Created2009-04-15

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