VS 4-54 Brucellosis Test Record Market Cattle Testing Program

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0579-0047

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UNITED STATES DEPARTMENT OF AGRICULTURE
STATE
BRUCELLOSIS TEST RECORD
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
MARKET CATTLE TESTING PROGRAM
VETERINARY SERVICES
ESTAB. NO.
SAMPLES DRAWN AT (“X” One)
LIVESTOCK MARKETS
SLAUGHTER ESTAB.
CERTIFICATTION
NAME AND ADDRESS OF PLACE WHERE SAMPLES WERE DRAWN
LABORATORY
I CERTIFY THAT I HAVE COLLECTED AND CORRECTLY
IDENTIFIED EACH BLOOD SAMPLE LISTED BELOW.
ADDRESS
SIGNATURE

DATE

DATE

SIGNATURE

TESTING LABORATORY

TEST RESULTS
NEG.
SUS.
REA.
TOTAL

SALES
TAG OR
BRAND

BACK TAG NUMBER

EAR TAG NUMBER

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

VS 4-54
SEP 2011

Previous editions are obsolete.

VACC.
TATTOO

AGE

BRE
ED

SEX

BAPA
RST

TUBE NO.

LABORATORY RESULTS
CAR
D

FPA

RIV

CF

TEST
IN
TREP.

HERD OWNER’S NAME

ADDRESS

COPY DESIGNATIONS
RED INK, RIGHT BOTTOM CORNER
PART 1 – OFFICE COPY
PART 2 – OFFICE COPY
PART 3 – OFFICE COPY
PART 4 – LIVESTOCK MARKET COPY