REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF AGRICULTURE
BUREAU OF FISHERIES AND AQUATIC RESOURCES
MASBATE PROVINCIAL FISHERIES OFFICE
MDFFN COMPOUND ,DAANG LUNGSOD, MOBO, MASBATE

_________________________________________________________________
SCIENTIFIC EXAMINATION REPORT
_______________
________________________
Date
__________________________
__________________________

Sir:

With reference to the fish samples submitted for scientific examination, I have the
honor to inform you of the following:

SOURCE OF FISH SAMPLE(s) : _________________________________

OWNER/OPERATOR/IN-CHARGE OF FISH: _________________________________
ADDRESS OF OPERATOR/IN-CHARGE OF FISH : ______________________________
DATE FISH SAMPLES TAKEN: __________________________________________
DATE FISH SAMPLES SUBMITTED :__________________________________________
DATE OF FISH SAMPLES EXAMINED: ________________________________________
SUBMITTED FOR EXAMINATION BY: ________________________________________
Designation/Rank/Position: ________________________________________

NAME OF FISH SAMPLES

Local Name Scientific Name No. Of pieces Remarks

1. _______________ _______________________ __________ __________
2. _______________ _______________________ __________ __________
3. _______________ _______________________ __________ __________
4. _______________ _______________________ __________ __________

CHARACTERISTICS OF THE FISH EXAMINED:

A. EXTERNAL MANIFESTATIONS:

1. _________________________________________________________________________
2. _________________________________________________________________________
3. _________________________________________________________________________
4. _________________________________________________________________________
5. _________________________________________________________________________

B. INTERNAL MANIFESTATIONS:

1. _________________________________________________________________________
2. _________________________________________________________________________
3. _________________________________________________________________________
4. _________________________________________________________________________
5. _________________________________________________________________________

CONCLUSION: _________________________________________________________
___________________________________________________________________________

Examined by:

____________________________
Fish Examiner
 REPUBLIC OF THE PHILIPPINES
DEPARTMENT OF AGRICULTURE
BUREAU OF FISHERIES AND AQUATIC RESOURCES
MASBATE PROVINCIAL FISHERIES OFFICE
MDFFN COMPOUND ,DAANG LUNGSOD, MOBO, MASBATE

_________________________________________________________________
SCIENTIFIC EXAMINATION REPORT
_______________
________________________
Date
__________________________
__________________________

Sir:

With reference to the fish samples submitted for scientific examination, I have the
honor to inform you of the following:

SOURCE OF FISH SAMPLE(s) : _________________________________

OWNER/OPERATOR/IN-CHARGE OF FISH: _________________________________
ADDRESS OF OPERATOR/IN-CHARGE OF FISH : ______________________________
DATE OF FISH SAMPLES EXAMINED: ________________________________________

NAME OF FISH SAMPLES

Local Name Scientific Name No. Of pieces Remarks

1. _______________ _______________________ __________ __________
2. _______________ _______________________ __________ __________
3. _______________ _______________________ __________ __________
4. _______________ _______________________ __________ __________

CHARACTERISTICS OF THE FISH EXAMINED:

B. EXTERNAL MANIFESTATIONS:

1. _________________________________________________________________________
2. _________________________________________________________________________
3. _________________________________________________________________________
4. _________________________________________________________________________
5. _________________________________________________________________________

B. INTERNAL MANIFESTATIONS:

1. _________________________________________________________________________
2. _________________________________________________________________________
3. _________________________________________________________________________
4. _________________________________________________________________________
5. _________________________________________________________________________

CONCLUSION: _________________________________________________________
___________________________________________________________________________

Examined by:

____________________________
Fish Examiner