VS 4-100 Log for Market Cattle Test Reactors

Brucellosis Program

4-100

Brucellosis Program - State

OMB: 0579-0047

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According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0047. The time required to complete this information collection is estimated to average .025 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

BOOK NO. PAGE NO.

UNITED STATES DEPARTMENT OF AGRICULTURE

ANIMAL AND PLANT HEALTH INSPECTION SERVICE

VETERINARY SERVICES

LOG FOR MARKET CATTLE TEST REACTORS




DATE

BLED




1




SAMPLES

TESTED AT




2




TEST RESULTS




3



RESULTS OF OPTIONAL TESTS



4




BACKTAG NUMBER




5



EARTAG OR

OTHER I.D.




6



CONSIGNOR

AND

ADDRESS




7


TOTAL

NO. CATTLE

IN THIS CONSIGN-MENT


8


DESTINATION

OF THE

NON-REACTOR CATTLE IN CONSIGNMENT



9




DATES OF FIELD INVESTIGATION




10



DATE

HERD

BLED




11

RESULTS OF

HERD TEST

REASONS IF HERD TEST CANCELLED OR POSTPONED





TOTAL TESTED





12



NEG.





13



SUSP.





14



RX.





15

OTHER COMMENTS




16



PLATE








INITIATED







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COMPLETED




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VS 4-100

APR 2009


File Typeapplication/msword
File TitleAccording to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond
AuthorKhbrown
Last Modified ByKhbrown
File Modified2009-04-14
File Created2009-04-14

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