B08 - DEATH RECORD Attachment 4.docx

Attachment 4

Bruneau Off Range Corrals Death Record/Report

DATE:

ID NUMBER:

CAUSE OF DEATH (PICK FROM FOLLOWING)

___GI – Gather Injury Complications ___LM - Lameness ___SH – Spinal/Head Injury ___BL – Blindness ___FC – Foaling Complications ___NT – No Teeth ___MY – Myopathy ___CD – Congenital Defect ___HM – Hemorrhage ___PS – Dangerous/Safety Hazard ___UN – Unadoptable ___ST – Struck by Lightning ___IT – Inflicted Trauma ___Euthanized ___Found Dead

SIGNED:

DATE:

HMA (if unmarked):

H-HORSE, B-BURRO, M-MULE:

SEX (F-FEMALE, M-MALE): AGE:

___PC – Chronic Poor Condition ___BF – Broken Limb ___RI – Respiratory Illness ___CL – Colic ___GC – Gelding Complications ___ST – Strangles ___LK – Liver/Kidney/Lipemia ___CT – Cancer/Tumors ___CN – Rabies-Central Nervous System ___NA – Neglect/Abuse ___OA – Old Age ___EI – Equine Infectious Anemia ___UD – Undiagnosed Comments (Required):