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Rodent Health and Safety Certificate Template

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向中华人民共和国出口实验用啮齿目活动物(仅限于无特定病原体小鼠、大鼠和豚鼠)遗传物质动物卫生证书

ANIMAL HEALTH CERTIFICATE FOR LIVE LABORATORY RODENTS(only for SPF MOUSE,RATS,GUINEAN PIGS)GENETIC MATERIAL TO THE PEOPLE’S REPUBLIC OF CHINA

证书编号/Certificate number: 页码/ Page:
出口国名称/Exporting country:总页数/Total nPages:

I. 供体动物信息/ Information on the donor animal(s):

种类
Breed
出生日期
Birth date
名称和注册号
Name and Registration number
收集日期
Collection date
供体代码
Code of donor
吸管(或冻存管)识别
Identification of vials(or tubes)
吸管(或冻存管)数量
Number of vials(or tubes)

II.货物来源/ Origin of the consignment:

发货人名称和地址/Name and address of consignor:
名称/Name:
地址/Address:

III. 货物目的地/ Destination of the consignment:

收货人名称和地址/Name and address of consignee:
名称/Name:
地址/Address:

液氮容器铅封号/Seal number of the liquid nitrogen container:
运输方式/Means of transport:
运输工具注册号/Vehicle registration number:

IV. Health information/健康信息:

作为该批精液/卵细胞/胚胎的检疫官,确认该批遗传物质仅用于科学研究,并符合以下要求:
The undersigned official veterinarian, certify that the above consignment of the semen or ova or embryo is intended for scientific research and satisfies the following requirements:

1.该批精液/卵细胞/胚胎供体动物为SPF动物,且符合以下要求:
The donor animals of the semen or ova or embryo are SPF and meet the following criteria.
1)供体动物自出生后一直在_的饲养设施内饲养,未与其他不同健康状态的动物接触,也未进行有关传染病和寄生虫的实验。
a)The donor animals were born and raised since births in the facility of ______and have remained isolated from animals not of equivalent health status. The donor animals have not been inoculated with any pathogens of infectious disease and parasites.
2)在过去的12个月内,该饲养设施未发生狂犬病、钩端螺旋体病、土拉杆菌病、猴痘、鼠疫、淋巴细胞脉络丛脑膜炎病毒病、肾综合征出血热、汉坦病毒肺综合征和鼠痘的临床病例。
b) During the 12 months prior to export,there has been no clinical or other evidence of rabies, leptospirosis, tularemia, monkey pox, plague, lymphocytic choriomeningitis virus, hemorrhagic fever with renal syndrome, hantavirus pulmonary syndrome and ectromelia or infectious agents in the facility.
3)该饲养设施符合输出国SPF动物设施标准,并在兽医的监管下进行饲养管理和卫生控制,且按照输出国SPF动物标准定期进行监测,符合标准要求。
c)The facility meets the standards of SPF animals of the export country. Feeding control and sanitary control are carried out under the supervision of a veterinarian. Surveillances and examinations were conducted periodically in the facility to confirm the animals comply with the standards of SPF animals of the export country.

  1. 输出动物遗传物质的收集、加工、清洗、储存过程,按照OIE推荐的卫生标准和IETS的手册进行。
  2. The semen or ova or embryo was collected and handled in accordance with the recommendations of the manual of the International Embryo Transfer Society (IETS) and the standards of the Office International des Epizooties (OIE) and was packed, stored and sealed under the supervision of the veterinarian.
  3. 每个经过冲洗透明带的胚胎须经显微境检查,以保证其透明带完整、无任何附着物。
  4. Each embryo was confirmed with an intact zona pellucida and free from adherent material by microscopic examination.
  5. 装运精液/卵细胞/胚胎的器具及运输工具用有效的消毒剂进行消毒处理。
  6. The container and vehicles used for semen or ova or embryo storing and transportation were disinfected with valid disinfectants.

Official Stamp印章官方兽医Office of Veterinarian

V. 本证书自颁发之日起,有效期______天/This certificate is valid for______day(s) from the date of signature.

签署地点Place of Issue                                 

签署Date of Issue

签名Signature

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