Farm Name: Product: Product: Size: Size: Rx Expiration Rx Expiration Unlimited Yes Unlimited Yes Date: Date: Quantity: Quantity: Quantity: Quantity: No No Refills: Refills: Animal ID Adult Lactating Youngstock Beef Animal ID Adult Lactating Youngstock Beef or Group or Group: Adult Non-Lactating Veal Other: Adult Non-Lactating Veal Other: Directions: Specify instructions below OR Directions: Specify instructions below OR Use according to label directions Use according to label directions Hold Milk Hours Hold Meat Days Hold Milk Hours Hold Meat Days Per Label Directions Per Label Directions Per Label Directions Per Label Directions Test milk/urine before marketing Test milk/urine before marketing Product: Product: Size: Size: Rx Expiration Rx Expiration Yes Yes Unlimited Unlimited Date: Date: Quantity: Quantity: Quantity: Quantity: No No Refills: Refills: Animal ID Adult Lactating Youngstock Beef Animal ID Adult Lactating Youngstock Beef or Group or Group: Adult Non-Lactating Veal Other: Adult Non-Lactating Veal Other : Directions: Specify instructions below OR Directions: Specify instructions below OR Use according to label directions Use according to label directions Hold Milk Hours Hold Meat Days Hold Milk Hours Hold Meat Days Per Label Directions Per Label Directions Per Label Directions Per Label Directions Test milk/urine before marketing Test milk/urine before marketing Product: Product: Size: Size: Rx Expiration Rx Expiration Yes Yes Unlimited Unlimited Date: Date: Quantity: Quantity: Quantity: Quantity: No No Refills: Refills: Animal ID Adult Lactating Youngstock Beef Animal ID Adult Lactating Youngstock Beef or Group or Group: Adult Non-Lactating Veal Other : Adult Non-Lactating Veal Other: Directions: Specify instructions below OR Directions: Specify instructions below OR Use according to label directions Use according to label directions Hold Milk Hours Hold Meat Days Hold Milk Hours Hold Meat Days Per Label Directions Per Label Directions Per Label Directions Per Label Directions Test milk/urine before marketing Test milk/urine before marketing
Farm Name: Product: Product: Size: Size: Unlimited Quantity: Yes Rx Expiration Date: Unlimited Quantity: Yes Rx Expiration Date: No Quantity: No Quantity: Refills: Refills: Animal ID or Group Adult Lactating Youngstock Beef Animal ID or Group: Adult Lactating Youngstock Beef Adult Non-Lactating Veal Other: Adult Non-Lactating Veal Other: Directions: Specify instructions below OR Use according to label directions Directions: Specify instructions below OR Use according to label directions Hold Milk Hours Per Label Directions Hold Meat Days Per Label Directions Hold Milk Hours Per Label Directions Hold Meat Days Per Label Directions Test milk/urine before marketing Test milk/urine before marketing Product: Product: Size: Size: Unlimited Quantity: Yes Rx Expiration Date: Unlimited Quantity: Yes Rx Expiration Date: No Quantity: No Quantity: Refills: Refills: Animal ID or Group Adult Lactating Youngstock Beef Animal ID or Group: Adult Lactating Youngstock Beef Adult Non-Lactating Veal Other: Adult Non-Lactating Veal Other : Directions: Specify instructions below OR Use according to label directions Directions: Specify instructions below OR Use according to label directions Hold Milk Hours Per Label Directions Hold Meat Days Per Label Directions Hold Milk Hours Per Label Directions Hold Meat Days Per Label Directions Test milk/urine before marketing Test milk/urine before marketing Product: Product: Size: Size: Unlimited Quantity: Yes Rx Expiration Date: Unlimited Quantity: Yes Rx Expiration Date: No Quantity: No Quantity: Refills: Refills: Animal ID or Group Adult Lactating Youngstock Beef Animal ID or Group: Adult Lactating Youngstock Beef Adult Non-Lactating Veal Other : Adult Non-Lactating Veal Other: Directions: Specify instructions below OR Use according to label directions Directions: Specify instructions below OR Use according to label directions Hold Milk Hours Per Label Directions Hold Meat Days Per Label Directions Hold Milk Hours Per Label Directions Hold Meat Days Per Label Directions Test milk/urine before marketing Test milk/urine before marketing
Prescription-Form.docx