RABIES VACCINATION CERTIFICATE

NASPHV FORM 51 (revised 2007).

RABIES TAG # 317237

Owner's Name & Address Print

Clearly

LAST FIRST M.I. TELEPHONE # 4147457906

RodrÃ-guez Carla

NO STREET CITY STATE ZIP

1. 1482 corbin New Britain CT 06053
Avenue

SPECIES AGE SIZE PREDOMINANT BREED PREDOMINANT

COLORS/MARKINGS

Dog Under 20
2 y,7 m,2 d lbs. Pug Black

SEX: Female
ANIMAL NAME

Animal Control License: 1 Yr

Kira

DATE VACCINATED Product Name: Veterinarian's Name:

Rabies (1 Year) Dr. Marianne Willis - CT

2022-07-17 Manufacturer: License Number:

ZOE
(First 3 letters)
Month / Day / Year
1455
1 Yr USDA Licensed Vaccine
NEXT VACCINATION
DUE BY: Initial Dose

557970
Veterinarian's Signature
Vaccine Serial (lot) Number
2023-07-17
Address:
Month / Day / Year
ShotVet Pharmacy

2950 Lake Emma Road

Suite 2030

Lake Mary, FL 32746

(407) 792-0384