D 28/30 D 28/30
D 14 D 14
D7 D7
D3 D3
Your next doses: 2. Your next doses: 5.
appropriate action. appropriate action.
unusual changes to the veterinarian for unusual changes to the veterinarian for
Observe the animal for 14 days. Report any 1. Observe the animal for 14 days. Report any 4.
Reminders: Reminders:
Department of Health Department of Health
National Rabies Prevention and Control Program National Rabies Prevention and Control Program
Rabies Prophylaxis Card Rabies Prophylaxis Card
RHU COLUMBIO ABTC RHU COLUMBIO ABTC
Animal Bite Treatment Center Animal Bite Treatment Center
COLUMBIO, SULTAN KUDARAT COLUMBIO, SULTAN KUDARAT
(Address) (Address)
9. 12.
D 28/30 D 28/30
D 14 D 14
D7 D7
D3 D3
Your next doses: 8. 11. Your next doses:
appropriate action. appropriate action.
unusual changes to the veterinarian for unusual changes to the veterinarian for
Observe the animal for 14 days. Report any 7. 10. Observe the animal for 14 days. Report any
Reminders: Reminders:
Department of Health Department of Health
National Rabies Prevention and Control Program National Rabies Prevention and Control Program
Rabies Prophylaxis Card Rabies Prophylaxis Card
RHU COLUMBIO ABTC RHU COLUMBIO ABTC
Animal Bite Treatment Center Animal Bite Treatment Center
COLUMBIO, SULTAN KUDARAT COLUMBIO, SULTAN KUDARAT
(Address) (Address)
Registration No.: _________________ Date Registered: _____________ Registration No.: _________________ Date Registered: _____________
Name: _________________________________ Age: _______________ Name: _________________________________ Age: _______________
Address: _______________________________ Sex: _______________ Address: _______________________________ Sex: _______________
Type of Prophylaxis Type of Prophylaxis
☐ Pre-exposure Prophylaxis ☑ Post-exposure Prophylaxis ☐ Pre-exposure Prophylaxis ☑ Post-exposure Prophylaxis
History of Exposure History of Exposure
Date of Exposure:___________________________________________ Date of Exposure:___________________________________________
Place of Exposure: __________________________________________ Place of Exposure: __________________________________________
Type of Exposure: BITE_at___________________________________ Type of Exposure: BITE_at___________________________________
Source of Exposure: _________________________________________ Source of Exposure: _________________________________________
Category of Exposure: ☐I ☐ II ☐ III Category of Exposure: ☐I ☐ II ☐ III
Post-exposure Prophylaxis: _____________________________________________ Post-exposure Prophylaxis: _____________________________________________
☐Washing of Bite Wound: __________________________________ ☐Washing of Bite Wound: __________________________________
☐ RIG: __________________________________________________ ☐ RIG: __________________________________________________
☐Anti-Rabies Vaccine ☐Anti-Rabies Vaccine
Generic Name: ____________________ Generic Name: ____________________
Brand Name: ______________________ Brand Name: ______________________
Route: ☐ ID ☐ IM Route: ☐ ID ☐ IM
D0 D3 D7 D14 (IM) D28/30 D0 D3 D7 D14 (IM) D28/30
*Proceed with D28/30 if the dog is not alive after 14 days of observation. *Proceed with D28/30 if the dog is not alive after 14 days of observation.
Status of Animal after D14 of Exposure: _________________________________ Status of Animal after D14 of Exposure: _________________________________
Remarks: Remarks:
__________________________________________________________ __________________________________________________________
__________________________________________________________ __________________________________________________________
__________________________________________________________ __________________________________________________________
Registration No.: _________________ Date Registered: _____________
__________________________________________________________
Name: _________________________________ Age: _______________ __________________________________________________________
Address: _______________________________ Sex: _______________ __________________________________________________________
Remarks:
Type of Prophylaxis
Status of Animal after D14 of Exposure: _________________________________
☐ Pre-exposure Prophylaxis ☑ Post-exposure Prophylaxis
*Proceed with D28/30 if the dog is not alive after 14 days of observation.
History of Exposure
Date of Exposure:___________________________________________ D28/30 D14 (IM) D7 D3 D0
Place of Exposure: __________________________________________
Type of Exposure: BITE_at___________________________________
Source of Exposure: _________________________________________ ☐ IM ☐ ID Route:
Brand Name: ______________________
Category of Exposure: ☐I ☐ II ☐ III Generic Name: ____________________
Post-exposure Prophylaxis: _____________________________________________ ☐Anti-Rabies Vaccine
☐Washing of Bite Wound: __________________________________ ☐ RIG: __________________________________________________
☐ RIG: __________________________________________________ ☐Washing of Bite Wound: __________________________________
☐Anti-Rabies Vaccine Post-exposure Prophylaxis: _____________________________________________
Generic Name: ____________________ Category of Exposure: ☐I ☐ II ☐ III
Brand Name: ______________________
Route: ☐ ID ☐ IM Source of Exposure: _________________________________________
Type of Exposure: BITE_at___________________________________
Place of Exposure: __________________________________________
D0 D3 D7 D14 (IM) D28/30 Date of Exposure:___________________________________________
*Proceed with D28/30 if the dog is not alive after 14 days of observation.
History of Exposure
☑ Post-exposure Prophylaxis ☐ Pre-exposure Prophylaxis
Status of Animal after D14 of Exposure: _________________________________
Type of Prophylaxis
Remarks:
__________________________________________________________ Address: _______________________________ Sex: _______________
__________________________________________________________ Name: _________________________________ Age: _______________
__________________________________________________________
Registration No.: _________________ Date Registered: _____________
