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U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
VETERINARY SERVICES
1. INSPECTION DATE
INDIVIDUAL ANIMAL INFORMATION REPORT
(For Flock Additions, Clinically Suspicious, Infected, and Traced Animals)
2. FLOCK NAME/CONTACT
3. FLOCK ID
4. INSPECTOR ID
(Obtain Flock letter from VS Form 5-19, block 23, if applicable.)
SECTION I - ANIMAL NO.
FLOCK LETTER
5. FLOCK TAG
6. REGISTRATION NUMBER
7. EARTAG
8. OFFICIAL ID NO. AND TYPE
9. SEX
10. BREED
11. DATE OF BIRTH
E
I
12. ENTRY DATE
14. FLOCK OF ORIGIN ID
15. DISPOSITION
M
F
O
T
W
13. FLOCK OF ORIGIN
Sold
16. SIRE EARTAG
17. SIRE OFFICIAL ID AND TYPE
20. DAM EARTAG
21. DAM OFFICIAL ID AND TYPE
24. DISPOSITION DATE
28. TEST TYPE
Loaned
Died
Slaughtered
Unknown
18. SIRE FLOCK TAG
19. SIRE REGISTRATION NUMBER
22. DAM FLOCK TAG
23. DAM REGISTRATION NUMBER
25. DISPOSITION FLOCK
26. DISPOSITION FLOCK ID
27. LAB RESULTS
29. SAMPLE DATE
30. DISEASE STATUS
31. DATE OF STATUS
E
I
E
O
T
I
O
T
32. CLINICAL SIGNS
33. REMARKS
E - Eartag
I - Implant
T - Tattoo
O - Other
(Obtain Flock letter from VS Form 5-19, block 23, if applicable.)
SECTION II - ANIMAL NO.
FLOCK LETTER
34. FLOCK TAG
35. REGISTRATION NUMBER
36. EARTAG
37. OFFICIAL ID NO. AND TYPE
38. SEX
39. BREED
40. DATE OF BIRTH
41. ENTRY DATE
43. FLOCK OF ORIGIN ID
44. DISPOSITION
E
M
F
42. FLOCK OF ORIGIN
I
O
T
W
Sold
45. SIRE EARTAG
46. SIRE OFFICIAL ID AND TYPE
49. DAM EARTAG
50. DAM OFFICIAL ID AND TYPE
53. DISPOSITION DATE
57. TEST TYPE
Loaned
Died
Slaughtered
Unknown
47. SIRE FLOCK TAG
48. SIRE REGISTRATION NUMBER
51. DAM FLOCK TAG
52. DAM REGISTRATION NUMBER
54. DISPOSITION FLOCK
55. DISPOSITION FLOCK ID
56. LAB RESULTS
58. SAMPLE DATE
59. DISEASE STATUS
60. DATE OF STATUS
E
E
I
I
T
T
O
O
61. CLINICAL SIGNS
62. REMARKS
VS FORM 5-20
DEC 2011
E - Eartag
I - Implant
T - Tattoo
O - Other
(Previous editions are obsolete.)
44. SIRE FLOCK TAG
45. SIRE REGISTRATION NUMBER
48. DAM FLOCK TAG
49. DAM REGISTRATION NUMBER
44. SIRE FLOCK TAG
45. SIRE REGISTRATION NUMBER
48. DAM FLOCK TAG
49. DAM REGISTRATION NUMBER
File Type | application/pdf |
File Title | InForms - vs5-20.wpf |
Author | kastratchko |
File Modified | 2011-12-13 |
File Created | 2008-04-09 |