În laboratorul veterinar ___________________________________________________
Adresa: ________________________________________________________________ Se îndreaptă pentru _____________________________________________________ Materialul patologic _____________________________________________________ (enumerați care) de la __________________________________________________________________ ( specia, vârsta animalului) Aparținînd _____________________________________________________________ (gospadăria, ferma, FNP proprietarului) Data îmbolnăvirii__________________________________________________________ Data morții______________________________________________________________ Tabloul clinic_____________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Data necropsiei anatomopatologice___________________________________________ Diagnosticul presupus______________________________________________________ Data trimiterii materialului__________________________________________________