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Guvernul României

ANSVSA
5 DSVSA
Paşaportul bovinei XX
Seria X 00.000.001
Prezentul paşaport s-a eliberat azi |_________________________|_______________________| / |_________________________|_______________________| / |_________________________|________________ _________|___________________________|
A
____________________| pentru animalul:

cu crotalia RO|_______________________________|_____________________ _________|_____________________________|_____________________________|_____________________________|_____________________________|_____________________________|_____________________________|__________________________|


____________________________|___________________________|__________________________| , respectiv codul de bare
Specie Rasă Sex Zi / Lună / An naştere
|_________________________|_______________________ | / _|__________________
________|_________________________| / |_________________________|__________-
______ _________|___________________________|____________________|

B Emitent,
Codul de identificare a mamei |___________________________|________________ _________|_____________________________|___ |_______________________________|_______________- Director Coordonator,
______ _________|_____________________________|_____________________________|_____________________________|_____________________________|_____________________________|_____________________________|__________________________|

____________________________|___________________________|__________________________ | LS
cod ţară număr crotalie DSVSA

Codul anterior animal |___________________________|________________ _________|_____________________________|___ |_______________________________|_____________________ _________|


_____________________________|_____________________________|_____________________________|_____________________________|_____________________________|_____________________________|__________________________|____________________________| Semnătura……………...
___________________________|__________________________ |
cod ţară număr crotalie

Data de intrare in ţară |_________________________|_______________________


DATELE EXPLOATAŢIEI IN CARE S-A EFECTUAT PRIMA IDENTIFICARE A BOVINEI
| / |_________________________|_______________________| / |_________________________|________________ _________|
C
Detinator:____________ Nume ________________________Prenume__________________CUI _______________________

Deţinător Medic veterinar


Judeţ ___________________ CSV _____________________________ Semnătura
Semnătura
Localitatea _________________________str. _________________ , nr._____ .............................

|_________________
Cod exploataţie RO |_________________________|________________ _________|________________________|________________________| ________|_______________________| /
________________________|________________________|
.......................... Parafă...................
________________________|________________________|________________________|______________________| ; Data: |_________________________|_______________________| /
D DATE DE IDENTIFICARE A EXPLOATAŢIILOR NOI
DEŢINĂTOR NOU: Nume ________________________________ Prenume _________________________________
Judeţ ____________________________ CSV ____________________________________ Medic veterinar
Semnătura
1 Localitatea ________________________str. _____________________ , nr._____ Semnătura deţinător
.................................
|_________________
Cod exploataţie RO |_________________________|________________ _________|________________________|________________________| ________|_______________________
________________________| | /
________________________|
............................... Parafă........................
________________________|________________________|________________________|______________________| ; Data: |_________________________|_______________________| /
DEŢINĂTOR NOU: Nume ________________________________ Prenume _________________________________
Judeţ ____________________________ CSV ____________________________________ Medic veterinar
Semnătura
2 Localitatea ________________________str. _____________________ , nr._____ Semnătura deţinător
.................................
|_________________
Cod exploataţie RO |_________________________|________________ _________|________________________|________________________| ________|_______________________
________________________| | /
________________________|
............................... Parafă........................
________________________|________________________|________________________|______________________| ; Data: |_________________________|_______________________| /
DEŢINĂTOR NOU: Nume ________________________________ Prenume _________________________________
Judeţ ____________________________ CSV ____________________________________ Medic veterinar
Semnătura
3 Localitatea ________________________str. _____________________ , nr._____ Semnătura deţinător
.................................
|_________________
Cod exploataţie RO |_________________________|________________ _________|________________________|________________________| ________|_______________________
________________________| | /
________________________|
............................... Parafă........................
________________________|________________________|________________________|______________________| ; Data: |_________________________|_______________________| /
DEŢINĂTOR NOU: Nume ________________________________ Prenume _________________________________
Raion ____________________________ CSV ____________________________________ Medic veterinar
Semnătura
4 Localitatea ________________________str. _____________________ , nr._____ Semnătura deţinător
.................................
|_________________
Cod exploataţie RO |_________________________|________________ _________|________________________|________________________| ________|_______________________
________________________| | /
________________________|
............................... Parafă........................
________________________|________________________|________________________|______________________| ; Data: |_________________________|_______________________| /
5 DEŢINĂTOR NOU: Nume ________________________________ Prenume _________________________________
Judeţ ____________________________ CSV ____________________________________ Medic veterinar
Semnătura
Localitatea ________________________str. _____________________ , nr._____ Semnătura deţinător
.................................
|_________________
Cod exploataţie RO |_________________________|________________ _________|________________________|________________________| ________|_______________________
________________________| | /
________________________|
............................... Parafă........................
________________________|________________________|________________________|______________________| ; Data: |_________________________|_______________________| /
E DATE REFERITOARE LA TĂIEREA / MORŢII BOVINEI:
Medic veterinar Proprietar abator
Data tăierii |_________________________|_______________________| / |_________________________|_______________________| / |_________________________|________________ _________|
Semnătura Semnătura
___________________________|____________________| ; Cod abator RO |_________________________|________________ _________|________________________|________________________|________________________|
................................. .................................
________________________|________________________|________________________|________________________|______________________ | Parafă........................ Stampila.......................
(zi) (lună) (an)

Data morţii/dispariţiei |_________________________|_______________________| / |_________________________|_______________________| / |_________________________|________________


_________|___________________________|____________________|