KOLKATA Street Dog Census

Edit Existing?

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

Owned Free Roaming
Color *
describe in detail
Age *

Puppy 0 - 8 months Adolescent 8 months - 3 years Adult 3 - 8 years Senior 8+ years
Sex *

Male Female Lactating Female Pregnant Female
Recognizable Feature
optional
Sterilized? *

Yes No (entire) not sure
Vaccinated? *

No DHPPi/ DHPPiL Rabies not sure
Date of DHPPiL Vaccine *
Date of Rabies Vaccine *
Rabies Batch Number *
ARV Validity *

1 year 3 years
Marking Method *

Unmarked With Paint With Collar
Any Injury/ Illness? *

None Malnourishment Mange Distemper Parvovirus Rabies Cancer Maggot Wound Open Wound Flea/Tick Illness HeartWorm Disease Limb Disfigurement Eye Problem Other - Please Specify
Please Describe Illness as You see it
Medical Notes
Is there a Responsible Local carer? *

Yes No
Carer Name

First Name Last Name
Carer Phone Number
Dog Temperament *

FRIENDLY /PETTING SCARED BUT APPROACHABLE INDIFFERENT SNAPPY /GROWLING/AGGRESSIVE UNAPPROACHABLE ATTACKING/BITING
No. of Rabies Cases in area in past 1 year? *
No. of RoadKills in the area in last year? *
Your Name *

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