POST-MORTEM CERTIFICATE
(To be issued by Registered Government Veterinary Practitioner Only)
1. Name of the Hospital/ institution if any: _______________________________________________________________________
2. Owner's Name & Address: _________________________________________________________________________________
______________________________________________________________________________________________________________
3. Species:
Breed: _ I................................I_____ Age: I …..I Sex: Female I…. I Male I…..I Colour:……….
Number of Lactations.......................... Last Calving Date: .......................... Pregnancy Status......................
4. Identification Mark: ________________________________________________________________________________________
5. Whether the carcass is of the insured cattle: O Yes O No (tick the correct answer)
6. Ear Tag No/ RFID No: ________________________________________
7. No. of Animal kept on Farm / house: _________________________________________________________________________
No. of Affected Animals: ____________________________________________________________________________________
8. HISTORY
(a) Where and when purchased: _____________________________________________________________________________
(b) Signs and lesions observed: _____________________________________________________________________________
(c) Date & Time of start of trouble: ___________________________________________________________________________
(d) Date & Time of death of animal: __________________________________________________________________________
(e) Number of animal died: __________________________________________________________________________________
(f) Date & Time of report received by Veterinary Surgeon : ______________________________________________________
(g) Date, time & place of Postmortem conducted: ______________________________________________________________
(i) Vaccination done if any, ___________________________________________________________________________________
9. GROSS FINDINGS
(a) GENERAL CONDITION OF ANIMAL: _____________________________________________________________________
(b) PRIMARY INCISION: ____________________________________________________________________________________
(Subcutaneous fat, muscles, peritoneum, position of viscera, body lymph nodes etc.)
(c) RESPIRATORY SYSTEM: _______________________________________________________________________________
(Larynx, trachea, bronchi, lymph nodes, lungs, pleura)
(d) HEART: ________________________________________________________________________________________________
(e) SPLEEN: _______________________________________________________________________________________________
(f) LIVER: _________________________________________________________________________________________________
(Gall bladder, bile ducts)
(g) GASTROINTESTINAL TRACT: ___________________________________________________________________________
(Mouth, tongue, esophagus, stomach, small intestine, caecum, colon, rectum and anus)
(h) URINARY SYSTEM: _____________________________________________________________________________________
(Kidneys, ureters, bladder, urethra
(i) GENITAL SYSTEM: _____________________________________________________________________________________
(Testis, epididymis, spermatic cord, prostate, seminal vesicles and bulbo-urethral glands, penis, ovaries, oviducts, uterus,
cervix, vagina, vulva)
(j) BONES & JOINTS: _______________________________________________________________________________________
(k) OVER ALL MUSCULATURE: _____________________________________________________________________________
(l) Findings/Observation on physical examination:
1
10. Detail of laboratory / Histopathological examination:
(a) Dispatch No. of sealed material: Date:…. /…. /20.......
(b) Name If Address of carrier:
____________________________________________________________________________
_______________________________________________________________________________________________
___________________
(c) Name & Address of the institution where the material has been sent for examination
_______________________________________________________________________________________________
_______________________________________________________________________________________________
______________________
(d) Detail of material collected: _________________________________________________________________
(e) Purpose for which material collected:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
(Histopathological, Bacteriological, Virological, Immunological, Chemical examination or any other purpose)
(f) Findings of Institution/ Laboratory: _________________________________________________________
12. Diagnosis (specifying reason of death) with cause _________________________________________________
I confirm the truthfulness of the statement made above after actual conduction of post
mortem of the animal and is right to the best of my knowledge and ability.
Date: __/____ 20___
Location: ___________ Signature of Veterinary: ____________________
Stamp: _______________________________
Name, Sign/thumb impression of
the person receiving report
with date. Name in block Letters __________________
Regn. No. : ___________________________
