4628. Neuter Certificate

 

Date:
VETERINARY SURGERY CERTIFICATE NUMBER:

TPV Ref Number: 
Name of Animal:

Microchip Number: Colour/Markings: Breed: Male/Female/Neutered/Spayed Age/Date of Birth:

I, a qualified veterinary surgeon, certify that I have had performed for the above-mentioned animal, the following procedures as ticked in the (   ):

(   ) spayed (   ) neutered (   ) certify that the above-mentioned dog is unfit for sterilisation and is unlikely to procreate (   ) Comments, if any On  Date:                                          Time:       Place:

NAME OF VETERINARY SURGEON:
SIGNATURE OF VETERINARY SURGEON
DATE AND STAMP: