HomeMy WebLinkAboutReport of Animal Bite - 2023T'O WN O F Y,&RE{ O UT E{v v10daolno'
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i146 ROUTE 28 SOUTIT tIR}IOUTIT
TelephoEe (508) 398-2231
MASSACHUSE'I|TS 02664
BOARD OF I{EALTH
REPORT OF AMMAL BITE
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Name
INYBSTIGATION OF REPORT /2
BITB VICTIM: Name:
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REPORTED BY:
ANIMAL:
BREED:
Date
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AddreBs:
Phone #:
Parent's Name (if child)
Age:
IVED
/X-S
NEAL I H DEPT
DATE BITE OCCURRED
PART OF BODY BITTEN
BITE TREATED BY:
NUMBBR OF PRIOR BITES
J 5,
Doctor
AMMAL OWNER: Name:
Address:
Phone #:5t7 56/- i0?b
Date
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Dog Cat Orher
rq^q],/t DEscRIPTtoN'gJ,,,J/e t/.r/i
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liate ,,/ ettered Ma-Ie Female-SDay Femate-Rabies Tag (ai,;/r
LiceDse # _ Runailg Loose _ Resrra
Otirer ,70).2
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DESCP.IP IiOr_ OF INCIDSNT :
:cTlc\ fiKE\ :.c=-;s: -:-:it:-l.L o!/NER (iltct^.J;n- a {,/r1-<--
Z8-Dec-2823 13116 fnom
Reporting Facilityi
*1s08394?320
NOTICE TO MUNICIPAL ANIMAL INSPECTOR OF POSSIBLE EXPOSURf TO RABIES
Date oi Noti(e \? 'a-r. ?3 Date of Erposure . 12,2b, af
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Reponer Namei Telephone Number 66r-q - 35br,,
l.Report to the Municipat Anirnal lnspector he tovfh wherelhe Biling Animal residesi {htlP5://swv.mair'8ov/d6'1tfluti'1Pal'icimal-inspectorrlst)
fhe existence of a domesti( animalthat cao be ideotifi€d and has bitten or scralched enothet domestic animal or a hurnan'
2.fieport to the Municipil Anirnal lnspector in the ro,rrn where the victlm animil r€sides: (httpt://ewrr.rna5s-8ov/da./munl.ipil'animal'inspedornisr)
The eristen.e ol a domestic animal that has beeh axposed to the rables virus by direct contact, prorimity ar bY a wound of unk6owh o'igin
lntpecto/sTown \acrnou+h.A n..", Schartl Ne\on --rax€d / carre.r Far {-Eee: -rq9-:91]5rer!phone*-@- !Q!l' Y9zz
Animal should be q!arantined due to {che(k .iate ml
oirect (ontact with a confirmed rabidanimal.
oirect contact with a suspect rabid .nimal {riccoon, slunk, woodchuckor aoy c.fnivorout a^imal)
A t(ound of uoknotYn oriSlo, luspected !o be cau'edbY another animal (e g' cat abs'ess€s)
-
A proximity exPoture to a coofirmed rabid animal {confi'med by stat€ Rab'es Laboratory)
-x_Dome5tjcanlmalbittenors(atchedbyctlott|erdoBe.ticonimalthathlsnoibeenid6ntified{o'qriarantihe
Oomestic animalwhich ha5 b,ftsn orscratched anolhet domenic animalor a human and cao b€ identified'
vrcrln fu)inrrl (vaccioatc lmrnediateiy, except in casct as listdd below)Eirins/scratching Animal {Do Not vaccifiate untilRabies quarantin€ i' fteleased}
1. p re\ior.rsly v:conated within 30 DaYs it LJnknown
2. Biria&/ Scratching animal is Domestl. alrd ldeotified for Quarantine ir wildlife Town of locident:
Oqner / caretale, Name .j Ow[€d Oome5tk Animal (Fill ln Belovr] O streY Domestic Animal {trll lo Below)
Telephone Number:Owner/ Gretaker Name
Street Address Sa\l
Soulh \tatrnou+h zip, f]zbbq
Species:-C00S9-- Anirnal Name
Sreed:6-<I.cf color. &rnd\C
oate of ta5t Rabies va(crnarion: -Ll:eil:3- Altach Fabies certifi<rte
ouratron: L- l Yearl [3(: veat] [--unknownl
Oate o[ Bo€Eter Vaccinatjon
Euthaai.ed E] Da!e:
-
RabiesTesting D Date:-
it victim h3s clienv Patient Fe{atlonship with Reporter
T€lephone Numberr
--
\?la-? 12? Att3ch Rabies certilicate
Eurhaniz€d B Date:
--
Sabi€sTe5ting ! oate:
fi Biting/Sctatch,ng animal ha! client/Patient Belarionship urith nepo.ter
n Human Victim (record below name,address, phone Rumb
Additional lnformalion:
leeg \oceruf'ton \o rnnec Cheeu l \it Qqt^croX S\j*uro Qtoa'm€o{n
1o,\rer* is on A0{'rbio}tu6 0or^,, roEci wCcrne urca to6o6{ere4 tacrt. (1"rzr la5)
Animal Questions or Cgo(eml? Rabies Ptogram coordlnator; 617-626-16l0 IhrtF!././'ww,{.rrDs.to!/serykcdddls/.able. proto.6k-r^d,e8xl.tiEns)
Human eStionS ga Conce?as ? Divislon o, E demi 617-983-5800
Notie ro Monicioal Arinel l',!p€aor S45,
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street Address:
city:
-
-.-...-zig:
-
Spe.ies: Animal Ntmei
-
Breed: Colon _- ...--=--
Dateof t.a5t Rabies vacclnation.
-
Att'ch Rabies CertificBte
Duretion: L- l yeari L- 3 Yearl L-Unknownl
. ZA'Dec-2823 l3:l? [rom:,15s8394?3Zg p.{
Vrrr*,*o*,
AssocrnrEs oF
CAPE COD
'16 Commonwealth Ave
South Yarmouth, MA 02664
Phone: (508)-394-3566
Eogil: Clientservices@capecodvets. com
RABIES TAGt 127-22
MICROCHIP:
TELEPHONE #
(508) 561-1696
Owner's Name & Address
Thayne Garvey
City, State
South Yarmouth
,MA
zip:
02664
Address:
47 Saltbox Rd
Current Weight:
223 lbs
Predominant Breed:
Mastiff
Animal Name:
Charlie-'.
Color:
brindle
Age:6Yrs.4Mos.
Sex: Neutered Male
Species:
Canine
Product Name: Rabies
- Canine 3 Year
Vaccination
Vaccine Expirationi
ail2423
Manufacturer:
USDA LICENSED VACC
3
Vaccin6 Serial (Lot) No.
18527
Type:
Address:
Veterinary Associates of Cape Cod
16 Commonwealth Avenue
South Yarmoulh, MA 02664
License Number: 7671
Phone: (50E) 3S4-3566
VGterinarian's Name:
Susan Neary. DVM
DATE
VACCINATED:
-\ ji)s.i\ili\ti
NEXT
VACCINATION
DUE BY:
"iiilsjrilii:\S I
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. Z$-Dec-?OZ3 13:16 Fronr:*15O83947328 p.3
Vrru*,*o*,
AssocrnrEs oF
CAPE COD
16 Commonwealth Ave
South Yarmouth, MA 02664
Phone: (508)-394-3566
Emaili Clientservices@capacodvets.com
.iffi'
RABIES TAG:003377-23
MICRGCHIP:
Owner's Name & Address
Thayne Garvey
TELEPHONE #
(508) 561-1696
Address:
47 Saltbox Rd
City, State
Soulh Yarmouth
.MA
Zipi
02664
Animal Name:
Charlie'--
Current Weight;
223 lbs
Predominanl Breed:
Mastiff
Species:
Canine
Age; 6 Yrs. 4 Mos.
Sex: Neutered Male
Color:
brindle
DATE
VACCINATED:
. \.i,.\-\:i.i\tii.i.\i\,
NEXT
VACCINATION
DUE BY:
\ l\)itlJs\\..\)s
Product Name: Rabies
- Canine 3 Year
Vaccine Expiration:
5t31t2025
Type: Killed Virus
Manufacturer:
Boehringer lngelheirn
USDA LICENSED VACG
3
vaccine Serial (Lot) No.
'18591
Veterinarian's Name:
Travis Lang, DVM
License Numberi 9645
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Address:
V6terinary Associates of Cape Cod
16 Commonwealth Avenue
South Yarmouth. MA 02664
Phone: (508) 394-3566