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ANI MAL SHELTER
: 481' 0
MAI LI NG ADDRESS
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ANIMAL
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( 7601
O N / I Y I E D I C A L
H I i
Pal nr Spr i ngs
CAMI NO PAROCELA,
PALM SPRI NGS,
CA 9?264
BOX 1830,
PALM SPRINGS, CA 92?63-1830
323- 8151
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ADOPTER'S NAME
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st er i l i zat i on
Dat e of Rabi es Vaccl nat i on
. , . . . - Dat e of Expi rat i on
**************************************ii*******l{ffi
c E R T I F I c A T E
o F , . , . , , t A B I E S
v A c c l N A T I 0 N
Thi s i s. t o cer t i f y
t hat t he above descr i bed
anl mal r ecei ved
a r abi es
vacci nat i on'
whi ch has been veri f i ed
by t hi s
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C E R T I F I C A
certi fy that the above
* * * * * * * * * *
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Thi s i s . t o
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st eri I i zed
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* * * * * * *
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T E . I } F
S T E R I L I T Y
descr i bed
ani mal has been sur gi cal l y
; ,
0 I i censed vet er i nar i an,
pr act i ci ng
Manufacturer
Type of Vaeci ne
Vet eri nari an
(
Name/ Address/
Phone)
t::'
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Met hod of I dent i f i cat i on
By
Lot Number--
Shelter staff
marked "M"
for Male
and "N" for
Neutered
This is Animal Medical Hospital, which was then owned and/or
operated by Dr. Kunz, Pres. of Friends of the Palm Springs
Animal Shelter
See attached receipt
CITY OF PALM SPRINGS
MISCEITANEOUS
RECEIPT
No.
134969
RECEIVED OF
THE SUM OF
IN
PAYMENT Of
ACCOUNT TO BE CR.EDITED
ORIGINAL