Sending Farm Name Receiving Farm Name Date Received MM slash DD slash YYYY Number Received For the following fields, please indicate the number of head showing the specified symptom. If none, enter '0'.Coughing - Number of Head Sneezing - Number of Head Snotty Noses - Number of Head Scours - Number of Head Less Than 5 lbs - Number of Head Ruptures - Number of Head Uncastrated - Number of Head Lames/Stiff Pigs - Number of Head Swollen/Malformed Joints - Number of Head Observable Abscesses or Prolapses - Number of Head General observations regarding pig quality and conditionsPhoneThis field is for validation purposes and should be left unchanged.
