POST-MORTEM CERTIFICATE

(To be issued by Registered Government Veterinary Practitioner Only)

1. Name of the Hospital/ institution if any: _______________________________________________________________________

2. Owner's Name & Address: _________________________________________________________________________________

______________________________________________________________________________________________________________
3. Species:
Breed: _ I................................I_____ Age: I …..I Sex: Female I…. I Male I…..I Colour:……….
Number of Lactations.......................... Last Calving Date: .......................... Pregnancy Status......................

4. Identification Mark: ________________________________________________________________________________________

5. Whether the carcass is of the insured cattle: O Yes O No (tick the correct answer)

6. Ear Tag No/ RFID No: ________________________________________

7. No. of Animal kept on Farm / house: _________________________________________________________________________

No. of Affected Animals: ____________________________________________________________________________________

8. HISTORY

(a) Where and when purchased: _____________________________________________________________________________

(b) Signs and lesions observed: _____________________________________________________________________________

(c) Date & Time of start of trouble: ___________________________________________________________________________

(d) Date & Time of death of animal: __________________________________________________________________________

(e) Number of animal died: __________________________________________________________________________________

(f) Date & Time of report received by Veterinary Surgeon : ______________________________________________________

(g) Date, time & place of Postmortem conducted: ______________________________________________________________

(i) Vaccination done if any, ___________________________________________________________________________________
9. GROSS FINDINGS
(a) GENERAL CONDITION OF ANIMAL: _____________________________________________________________________
(b) PRIMARY INCISION: ____________________________________________________________________________________
(Subcutaneous fat, muscles, peritoneum, position of viscera, body lymph nodes etc.)
(c) RESPIRATORY SYSTEM: _______________________________________________________________________________
(Larynx, trachea, bronchi, lymph nodes, lungs, pleura)
(d) HEART: ________________________________________________________________________________________________
(e) SPLEEN: _______________________________________________________________________________________________
(f) LIVER: _________________________________________________________________________________________________
(Gall bladder, bile ducts)
(g) GASTROINTESTINAL TRACT: ___________________________________________________________________________
(Mouth, tongue, esophagus, stomach, small intestine, caecum, colon, rectum and anus)
(h) URINARY SYSTEM: _____________________________________________________________________________________
(Kidneys, ureters, bladder, urethra
(i) GENITAL SYSTEM: _____________________________________________________________________________________
(Testis, epididymis, spermatic cord, prostate, seminal vesicles and bulbo-urethral glands, penis, ovaries, oviducts, uterus,
cervix, vagina, vulva)
(j) BONES & JOINTS: _______________________________________________________________________________________
(k) OVER ALL MUSCULATURE: _____________________________________________________________________________

(l) Findings/Observation on physical examination:

1
 10. Detail of laboratory / Histopathological examination:
(a) Dispatch No. of sealed material: Date:…. /…. /20.......

(b) Name If Address of carrier:

____________________________________________________________________________
_______________________________________________________________________________________________
___________________
(c) Name & Address of the institution where the material has been sent for examination

_______________________________________________________________________________________________
_______________________________________________________________________________________________
______________________

(d) Detail of material collected: _________________________________________________________________

(e) Purpose for which material collected:

_______________________________________________________________________________________________
_______________________________________________________________________________________________
(Histopathological, Bacteriological, Virological, Immunological, Chemical examination or any other purpose)
(f) Findings of Institution/ Laboratory: _________________________________________________________

12. Diagnosis (specifying reason of death) with cause _________________________________________________

I confirm the truthfulness of the statement made above after actual conduction of post
mortem of the animal and is right to the best of my knowledge and ability.

Date: __/____ 20___

Location: ___________ Signature of Veterinary: ____________________

Stamp: _______________________________

Name, Sign/thumb impression of

the person receiving report
with date. Name in block Letters __________________
Regn. No. : ___________________________