Owner's Name & Address Print Clearly LAST FIRST M.I ...
Owner's Name & Address Print Clearly MICROCHIP # LAST FIRST M.I. TELEPHONE # NO. STREET CITY STATE ZIP SPECIES AGE SIZE PREDOMINANT BREED PREDOMINANT Dog Months Under 20 lbs. COLORS/MARKINGS Cat Years 20 - 50 lbs. Ferret SEX Male Over 50 lbs. Other: Female ANIMAL NAME (specify) Neutered Animal Control License 1 Yr 3 Yr Other ...
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