Hoja de Informaci贸n Canina
Fecha...................................
PROPIETARIO
APELLIDO( Sr./ Sta./ Sra.).......................................NOMBRE .......................................................
DIRECCION ......................................................................................................................................
............................................................................................................................................................
C贸digo postal..............................................
Tel. (ma帽ana) ..................................................... (tarde) ...................................................................
Fax ....................................................Correo electr贸nico...................................................................
INFORMACI脫N DEL ANIMAL
Nombre ..................................... Raza .................................. (Si es un cruce puro escriba la raza predominante, por ejemplo: Pequin茅s x Terrier, si no, cruzado o mestizo)
Color............................................. Capa............................... Sexo ...............................................
Fecha de nacimiento/edad...............................................................................................................
Identificaci贸n..............................................................................................................................
Tatuaje............................... Microchip..................... Otros........................................................
D铆a de adquisici贸n .................................................. Lugar de adquisici贸n.............................................................
Fecha de vacunaci贸n. Vacuna ...........................................................................................................
Contra qu茅 enfermedades..................................................................................................................
Fecha de revacunaci贸n.................................
Resumen de desparasitaci贸n y control de pulgas..............................................................................
驴Tiene usted alguna otra mascota? Por favor escriba resumidamente los detalles e historia cl铆nica. ..................................................................................................................................................
.......................................................................................................................................
Historia
Fecha del 煤ltimo tratamiento..........................................................................................
Nombre y direcci贸n del Veterinario ..................................................................................................
驴Sigue teniendo alg煤n problema?.......................................................................................................
.......................................................................................................................................
PROBLEMA ACTUAL ..................................................................................................................
Duraci贸n ............................................................................................................................................
驴Hay alg煤n otro animal afectado?.....................................................................................................
漏 Copyright 2025 LifeLearn Inc. Used and/or modified with permission under license. This content written by LifeLearn Animal Health (LifeLearn Inc.) is licensed to this practice for the personal use of our clients. Any copying, printing or further distribution is prohibited without the express written consent of LifeLearn. This content does not contain all available information for any referenced medications and has not been reviewed by the FDA Center for Veterinary Medicine, or Health Canada Veterinary Drugs Directorate. This content may help answer commonly asked questions, but is not a substitute for medical advice, or a proper consultation and/or clinical examination of your pet by a veterinarian. Please contact your veterinarian if you have any questions or concerns about your pet鈥檚 health. Last updated on Apr 11, 2011.