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[]
[null,"別記様式第４号の５"]
[null,"Attached Certificate"]
[]
[null," for dogs, cats, foxes, raccoons, or skunks to be imported into Japan"]
[]
[null,"N.B.) This certificate is used ONLY FOR ATTACHMENT to Form AB, Form AC or Form RE."]
[]
[null,"Either type or write clearly in BLOCK letters in English. Do not use pencils or erasable ink to fill in.\nNo correction fluid shall be used. The original entry shall be struck through and remain legible. \nThe correction shall be written adjacent to the original and signed."]
[]
[]
[null,"IDENTIFICATION OF ANIMAL"]
[null,"Microchip number",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Name"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"RABIES VACCINATION\n*Please write from latest one",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(produced in accordance with OIE standard)"]
[null,"Date of vaccination\n(yyyy/mm/dd)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Vaccine effective period (year)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Name of product and manufacturer\n*Type of vaccine should be inactivated or recombinant"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"year(s)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"year(s)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"year(s)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"year(s)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"year(s)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"year(s)"]
[null,"RABIES SEROLOGICAL TEST"]
[null,"Date of blood drawing\n(yyyy/mm/dd)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Antibody titer\n(IU/ml)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"The designated laboratory"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Name ："]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Country ："]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Name ："]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Country ："]
[null,"OTHER VACCINATION (if applicable)"]
[null,"Date of vaccination\n(yyyy/mm/dd)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Vaccine effective period\n(year or month)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Kind of vaccination",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Name of product and manufacturer"]
[]
[]
[]
[null,"REMARKS"]
[]
[null,"ENDORSEMENT BY OFFICIAL GOVERNMENT VETERINARIAN"]
[]
[null,null,"I certify that the followings;"]
[]
[null,null," ・ to the best of my knowledge and belief, all the details mentioned above are true and correct."]
[null,null," ・ this certificate is attached to Form AB* / Form AC* / Form RE*.    *Delete as appropriate"]
[]
[]
[]
[]
[]
[null,null," Signature:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"OFFICIAL GOVERNMENT STAMP"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," Date (yyyy/mm/dd):"]