Upozornění: Text přílohy byl získán strojově a nemusí přesně odpovídat originálu. Zejména u strojově nečitelných smluv, kde jsme použili OCR. originál smlouvy stáhnete odsud
Appendix 1
CASE REPORT FORM
VETERINARIAN’s Name (Capital letters): OWNER’s Name :
Post Code :
City :
Signatuře:
CATTLE: Dairy Beef Calf Veal Calf
SWINE: Sow Piglets (BW <15 kg) Weaner (15 - 40 kg) Fattening píg
POULTRY: Layer Broiler Breeder ElTurkey
IDENTIFICATION: Name or number: Age:
Breed:
HERD/FLOCK size (number of animals):
CLINICAL SIGNS: Diarrhoea Respirátory Mastitis Metritis Septicaemía
Lameness
SAMPLING OCCASION:
Animal that was not treated with antibiotics 15 (21 for mastitis) days prior to sampling: Yes No
Live animal At necropsy
Nasopharyngeal Swab Nasal swab
Bronchoalveolar lavage Faeces sample
Lung (or Air Sac) Faecal swab O
Milk sample Uterine swab
Urine sample Intestines
Other (please specify):
PATE OF OUTBREAK : /....../20__ *(if applicable)
PATE OF SAMPLING : ...... /...... /20_
OTHER COMMENTS :
To be completed by the veterinarian and sent with the sample to the laboratory selected
Laboratory Name : Laboratory N° of Sample :
Signátuře: ________________________________________________ Library Sample
STRAIN ISOLATED (genus species): Page 12 of 14
Serotyping (Optional)