INJURY REPORT

Serial No .
Date
Dr.Veterinary Hosp.
Time of Exam..Place of Exam
This is to certify that at the request of (1) ..........

Vide his/ their letter/reference No..date

I have on this the day of.examined
(Date)
(Month & Year)
(2)..Having the following identification marks.........
(kind of animal)
.
.
belonging to (3) (Name and address of the owner of the animal)
..The said animal has got the
following injuries on its body.
(4)..
..
Opinion as to the cause of injuries..

Nature of injuries (Grievious or Simple)

Age of injuries (Approx. nearest time)
Signature
Name.
Place..

Designation..

Date..

R.V.C. No.

INSTRUCTIONS:
1. Name of the party, Police Officer or Magistrate who has sent the
animal . If from a Police Officer or Magistrate, the number and date of
the letter should be given
2. The species, breed, sex and colour of the animal examined, with full
identification marks.
3. If received through a constable his number and the Station to which
he belongs .If through a Messenger (in private cases) the name of
the messenger should be given or name and address of the owner.
4. The nature of the injuries, i.e. cuts, fracture etc. with exact
measurement and position, Cause of the injuries, i.e. with sharp or
blunt instrument etc. Whether it is a permanent injury of could be
cured in a definite period under treatment.