16
AUG 19 2021 anit:
FAYN REPORT FORM lll
Rabies Antibody Titer for Export Animals
The Rabies Laboratory Phone: 785-532-4483 R21-044710 ~
Kansas State University Fax : 785-532-4474 artev2021
2005 Research Park Circle Email: rabies@vet k-state edu
Kansas StateVeterinary Manhattan, KS 66502 http://www.ksvdl.org/rabies-laboratory/
DIAGNOSTIC LABORATORY
Results are reported om this form. Please complete on-line and printout. If handwritten, print clearly. Handvritten information is
subject to interpretation by laboratory personnel. Once submited, information cannot be sltered*. Required fields are bolded.
Destination of animal being exported: UNITED STATES OF AMERICA.
Destination information is for laboratory report aisivbutton only.
Submitting Clinic: TEST LABORATORIO SAS Phone: 5742542298
Veterinarian Name: LUIS RUA CEBALLOS Fax: _ 5742542298
Clinic Mailing Address: CRA 45 D # 60-16- BARRIO PRADO CENTRO Emit. _*#t#oenioviaraieayna con
MEDELLIN State/Country: ANTIOQ ; COLOMBIA zipcode: 050012
Owner Name: First JENNIFER Last GRANADA MONCADA
Animal Name; LOLA
Microchip Number: 900 217 000 290 775 Serum Draw Date (mmddyy: US)_12 , 2021
{Wibere are two microchip amber nly he ft one wll oT TBE.
Species Breed: CANINE/SHIHT-2U Sex: MEQ Fil Age. FEB/19/2018
Rabies Vaccination History; JULY/10/2021-RABISIN/MERIAL/483555
Vaccination history s for laboratory reference only. Pease include up to thre recent waccnations dex availabe
Samples and test data may be used for general rescarch without compromising client confidentiality. [L} Opr Our
Date éantnysy AUS 18 2021
Signature of Veterinai
Signature affirms tha the above informatie Comet rd ik microchip ramBer Was Boon wre
‘Test willbe cancelled if sample tube is unlabeled or arrives without the microchip number*,
LaBe: R21-0447101 Rec'd Date: AUGUST 19, 2021
Microchip #: 9021700029075
‘The serum sample has been tested for antbodies to rabies
Virus by he OE-FAVN test and found to have a tter of
fe 4.56 IU/mL.
Jamie Henningson DVM, PHD, DACVP - KSVDL Director
‘Air of 9.50 Uil or above incals an acceptate rabies aod ive forthe
Purpose of export Fer repo weston, goto nw kad oration’
For Lab Use Only: Opened by Wai Processed By: yOB/fa/ao
Transferred By:__ tw) yer Payment Received: 12083, B47 1
* Pose se instrustons for FAN submission and reporting hp Aww kd oreabieslabatory This submission form is lps and binding contact,
between KSVDL and the submiting enuty. Specimens submited become te properly of the KSVDL. All fees, o include eollecuon fees, are he
esponsibility of the stenting entity and all enes must adhere tothe bling ply Fees may be pid by check (gayabie to Kanses State Univers),
‘Crt ar ney order or leon bank ranaer A I.5% fininae charge vil be assessed onal charges over 80 days. veanora816
AUG 192021 at
FAVN REPORT FORM HN DN)
Rabies Antibody Titer for Export Animals
The Rabies Laboratory Phone: 785-532-4483 21,044710--) -
Kansas State University Fax: 785-532-4474 osrter2ca4
2005 Research Park Circle Email: rabies@vet k-state.edu§ ————
Kansas State Veterinary Manhattan, KS 66502 http://w wdl.org/rabies-laboratory/
DIAGNOSTIC LABORATORY
Results are reported on this form, Please complete oncline and printout IC handwritten, prin clearly. Handwritten information is
subject to interpretation by laboratory personnel, Once submitted, information cannot be alieed*. Required fields are bolded.
Destination of animal being exported: UNITED STATES OF AMERICA,
Destination information sor laboratory report dsribution on
Submitting Clinic: TEST LABORATORIO SAS Phone: 5742542298
Veterinarian Name: LUIS RUA CEBALLOS: Fax; _ 5742542298
Clinic Mailing Address: CRA 45 D # 60-16- BARRIO PRADO CENTRO pri, _sitowrowurainanaicon
City; MEDELLIN State/Country: ANTIOQ ; COLOMBIA zipcode: 050012
Owner Name: First JENNIFER Last GRANADA MONCADA
Animal Name: COCO
Microchip Number: 900 217 000 290 784 Serum Draw Date am/dyyyyy AUS) 12 1 2021
{thre are tac microchip aber, ony the fat oe wi On He Peal Tbe] aw
Species/Breed: CANINE/SHIHT-2U See MIMMFEQ Age MARCH/O1/2018
Rabies Vaccination History, JULY/10/2021-RABISIN/MERIAL/470733,
Vaccination History for laboratory reference only Please elude upto three recent vxcinalions dates aval
Samples and st data may be used for general research without compromising clint conideataliy. [L} Op Oat
Signature of Veterinarian: atid Lid Date tmmayyyyy AUS _15 , 2021
Signature afrms that the above information Is Correct and he microchip raonber has been verVied
‘Test will be cancelled if sample tube is unlabeled or arives without the microchip number*
LABH: R21-0447102 Rec Date: AUGUST 19, 2021
Microchip #: 900217000290784
‘The serum sample has been tested for antbodies to rabies
‘us by the OIE-FAVN test and found to have ater of,
>is 4.56 [U/mL
Jamie Henningson DVM, PHD, DACVP ~ KSVDL Director
‘Ate 20 Ut above date an accep bin a ee a be
‘Purpose of export For epot vefonion, go wane kav sable brary
EEE
For Lab Use Only: Opened by [HS)Aht Processed By. NO 8/14/20.
Transferred By: WOM Payment Received: 2% 2042036 ig
+ Pleas se instretons for FAVN submission and reporting a hip Aww kau ulubislsboaton’ This submission form ie lega and binding contract
hawoen ESVDE and th submiting eatiy, Specimens submitted become the property of the KSVDL. All evs, to inclode collestion es, are the
‘aponsiby ofthe submiting entity ill entities ust adore tothe filing pole. Peek may be paid by check (payable to Kansas Sate Universit),
‘ret ean, mone) order. or elstoni bank trnafer 1.5% nance charge wil be esessed an ll charges over 60 days Vm?