CLONE
GERMANY
Dr. Carola Möhrke
Dorneystrasse 65
44149 Dortmund
Germany
STUD DOG
Phone: +4923196787910
OWNER
breed
name
birth
chip
tattoo
reg.no.
surname
first name
address
city
ZIP
country
Declaration by stud owner
Veterinary Certificate
I hereby certify that the dog describe above,
from which semen has been collected, is the
alleged dog, which rightfully belongs to me.
I hereby certify that the dog described
above was presented for semen collection
on
At the time of semen collection the dog was
clinically examined and found to be free
from any signs of disease. The dog has had
two testicles, normally developed, in the
scrotum.
signature of veterinarian
date
signature of owner
SEMEN DETAILS
frozen semen
packaging: straws 0,5ml
type of extender: CloneInc.
recommended thawing procedure: see frozen semen insemination instructions
straws
straw ID
Motility
abnorm.
sperms
motile
sp/
straw x
106
* single insemination or divided in two portions
Discontinue of FROZEN SEMEN
I hereby authorize the discontinue of the straws listed above.
TO:
surname
address
first name
city
date
signature of owner
ZIP
country
recommended
straws*