Report of Physical Examination of Cows FORM FDA-1995 PSC Graphics

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Specifications	Report of Physical Examination of Cows FORM FDA-1995 PSC Graphics
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*Where temperature or pulse is higher than normal, but the animal is otherwise apparently normal, notation should be made as

Specifications	Report of Physical Examination of Cows FORM FDA-1995 PSC Graphics
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Content	Where temperature or pulse is higher than normal, but the animal is otherwise apparently normal, notation should be made as to the condition of exercise or excitement under which the temperature and pulse were taken. Milk or cream from unhealthy cows must be so disposed of as to prevent its introduction into the United States, and certificate of owner of cows, stating how such milk or cream will be disposed of, must be given on the other side of this form. Use additional forms if this space is insufficient for reporting all cows in herd. CONCLUSIONS (Healthy or Unhealthy) DEPARTMENT OF HEALTH AND HUMAN SERVICES FOOD AND DRUG ADMINISTRATION REPORT OF PHYSICAL EXAMINATION OF COWS Required for Introduction into the United States of Milk and Cream under the Federal Import Milk Act Form Approved: OMB No. 0910-0212 Expiration Date: June 30, 2012 See Reverse for OMB Statement (OVER) PREVIOUS EDITION IS OBSOLETE. 2 AGEGENERAL CONDITION TEMPERA- TURE*PULSECOUGHUDDERSYMPTOMS OF DISEASE ANI- MAL NO. 1 4 3 5 6 7 8 9 10 11 12 IDENTIFICATION OF ANIMAL (Accurate description or ear tag number or registration name and number) (Veterinary Degree) (Official Connection) I HEREBY CERTIFY that I have made a physical examination of thecows above described, with results as stated. (Signed) (Address) FORM FDA 1995 (8/09) OwnerDate of examination AddressLocation of herd PSC Graphics (301) 443-1090EF
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