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58 Notice of Possible Rabis Exposure 2004 009 11:47P FROM: TO:14135071PP1 P.1/1 Northampton Veterinary Clinic 227 South Street Northampton, MA 01060 �� (413) 584-6309 Notice of Possible Exposure To Rabies The following animal was seen at our practice and presented with wounds from: 1) A confirmed rabid animal (tested positive at State Lab) 2)A suspected rabid animal (raccoon, skunk, woodchuck, fox,bat,etc.) ,-y- 7( 3) An unknown source(likely to be another animal) 4)No wounds,but was in proximity to an animal that tested positive for rabies at the State Lb Date of Exposure (or date seen): Owners Name:E./Pt1Y(3lnfolk US Phone: (4j2 )` %L1- [0.31Q7 Address:a CflUA kit [ .kit, Town: W is ijll'6Yt Zip: %Ma() Type of Animal: [Dog_) [Cat [ lOther_l(specify) Age:A.1,[)'s Name of Animal:ILla { v Breed: t)F,FI Colors: ariirx t t r%P Date of last vaccination: 5IIQ10(1 Duration: [1yrkl 1113yr_l [unknown_] Date of booster vaccination (given to current vaccinates only): �iQ10� Name of Veterinarian: LIU— 94\Lkicit flits Phone: C4e5SLI-Loam