VS 5-29 Cooperative State - Scrapie Control Program

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OMB APPROVED 0579-0101
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Rectal Biopsy
Sample Loc
(circle one #)3

Number Format: State abbreviation, collector's initials, collection date.

farms where a scrapie risk factor questionnaire was completed, check appropriate

3For

animals that may be sampled multiple times, e.g. SFCP or Exposed animals, circle
the quadrant where the biopsy sample was collected.

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