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Registered Name Registration number Microchip number Vet stamp Veterinarian Signature Date Dental Certificate Please type or print legibly. Scan this as a pdf and upload against your dog on Dogs NZ website. Logon and under my dogs on your home page you can upload test against the dog. If posng send to Dogs New Zealand, Private Bag 50903, Porirua 5240. Phone: (04) 237-4489 www.dogsnz.org.nz Any comment _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ I hereby certify that the information contained in this certificate is true and correct to the best of my professional knowledge at the time of examination. Veterinary surgeon submitting information Address Dentition - Full (42) Yes No If incomplete please indicate missing teeth on diagram provided BITE (please sign correct box) If additional teeth please note: ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ Incisors 3 2 1 1 2 3 Incisors 3 2 1 1 2 3 Lower Jaw Upper Jaw Molars Pre Molars Canines 1 1 1 1 2 2 2 2 3 3 3 4 4 } } } }
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Dental Certificate - nds2017.dogsnz.org.nz · Registered Name Registration number Microchip number Vet stamp Veterinarian Signature Date Dental Certificate Please type or print legibly.

Jul 19, 2020

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Page 1: Dental Certificate - nds2017.dogsnz.org.nz · Registered Name Registration number Microchip number Vet stamp Veterinarian Signature Date Dental Certificate Please type or print legibly.

Registered Name Registration number

Microchip number

Vet stamp

Veterinarian Signature Date

Dental Certificate Please type or print legibly. Scan this as a pdf and upload against your dog on Dogs NZ website. Logon and under my dogs on your home page you can upload test against the dog. If posting send to Dogs New Zealand, Private Bag 50903, Porirua 5240. Phone: (04) 237-4489 www.dogsnz.org.nz

Any comment

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

I hereby certify that the information contained in this certificate is true and correct to the best of my professional knowledge at the time of examination.

Veterinary surgeon submitting information

Address

Dentition - Full (42) Yes No

If incomplete please indicate missing teeth on diagram provided

BITE (please sign correct box)

If additional teeth please note:

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

Incisors3 2 1 1 2 3

Incisors3 2 1 1 2 3

LowerJaw

UpperJawMolars

Pre Molars

Canines

1

1

1

12

2

2

23

3

34

4

}} }

}