KOLKATA Street Dog Census

Edit Existing?

Canine Counts.
Location of DOG to be REGISTERED*
Ward Number
MotoPaws Collar Code
Name
Ownership Status*

OwnedFree Roaming
Color*
describe in detail
Age*

Puppy 0 - 8 monthsAdolescent 8 months - 3 yearsAdult 3 - 8 yearsSenior 8+ years
Sex*

MaleFemaleLactating FemalePregnant Female
Recognizable Feature
optional
Sterilized?*

YesNo (entire)not sure
Vaccinated?*

NoDHPPi/ DHPPiLRabiesnot sure
Date of DHPPiL Vaccine*
Date of Rabies Vaccine*
Rabies Batch Number*
ARV Validity*

1 year3 years
Marking Method*

UnmarkedWith PaintWith Collar
Any Injury/ Illness?*

NoneMalnourishmentMangeDistemperParvovirusRabiesCancerMaggot WoundOpen WoundFlea/Tick IllnessHeartWorm DiseaseLimb DisfigurementEye ProblemOther - Please Specify
Please Describe Illness as You see it
Medical Notes
Is there a Responsible Local carer?*

YesNo
Carer Name

First NameLast Name
Carer Phone Number
Dog Temperament*

FRIENDLY /PETTINGSCARED BUT APPROACHABLEINDIFFERENTSNAPPY /GROWLING/AGGRESSIVEUNAPPROACHABLEATTACKING/BITING
No. of Rabies Cases in area in past 1 year?*
No. of RoadKills in the area in last year?*
Your Name*

First NameLast Name
Your Phone Number
Your Email
Should be Empty: