Name of Owner : _____________________________

Village : _____________________________________

Block : _______________________________________

Contact Number : _____________________________

Tag ID of Cow : _______________________________

Remark
Calved Yes /No

Last date of Calving

Sex of Calf

Deworming details

Particulars I II III IV

Date of Deworming

Name of Dewormer

Vaccination details

Particulars I II III IV V VI

Vaccine Name

Date of Vaccination
Date Activity/Action Signature