Enclosure_4_-_Death_Report.pdf

PDF 11 KB Posted May 27, 2015

Attached to: Vet Services at BLM Palomino Valley
Solicitation number: L15PS00416
Issued by: Department of the Interior Bureau of Land Management National Office

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Enclosure 4 - National WH B Facility at Palomino Valley - Death Report

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ENCLOSURE 4

NATIONAL WH&B CENTER

AT PALOMINO VALLEY

DEATH REPORT

DATE:_______________________ (COMPLETE THIS SIDE IF ANIMAL UNMARKED)

HERD AREA:________________________

ID NUMBER:_________________ ____(H-HORSE, B-BURRO, M-MULE)

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

CAUSE OF DEATH: (PICK FROM THE FOLLOWING)

___GI GATHER INJURY COMPLICATIONS ___PC CHRONIC POOR CONDITION

___LM LAMENESS ___BF BROKEN LIMB

___SH SPINAL/HEAD INJURY ___RI RESPIRATORY ILLNESS

___BL BLINDNESS ___CL COLIC

___FC FOALING COMPLICATIONS ___GC GELDING COMPLICATIONS

___NT NO TEETH ___ST STRANGLES

___MY MYOPATHY ___LK LIVER/KIDNEY/LIPEMIA

___CD CONGENITAL DEFECT ___CT CANCER/TUMORS

___HM HEMORRHAGE ___CN RABIES-CENTRAL NERVOUS SYSTEM

___PS DANGEROUS/SAFETY HAZARD ___NA NEGLECT/ABUSE

___UN UNADOPTABLE ___OA OLD AGE

___ST STRUCK BY LIGHTNING ___EI EQUINE INFECTIOUS ANEMIA

___IT INFLICTED TRAUMA ___UD UNDIAGNOSED

___EUTHANIZED ___FOUND DEAD COMMENT: (REQUIRED)

SIGNED__________________________________