Veterinary Epidemiology and Zoonosis

MODEL PROFORMA FOR COLLECTION OF EPIDEMIOLOGICAL DATA

1. S. No.:                                                                               

• Date:

2. Name of the owner (s):

3. Address of the owner:

• Phone: 
• Mobile:

4. Details of the farm owner:

5. Family particulars:

6. Labour particulars:                                   

• Family labour / Private labour:
• No. of sheds / animals attended per day:
• Health status of labour:

7. Topography of the farm:

• Location: Hills / Pains / Valley / others
• Area: Urban / Rural / Semi urban

8. Nearest main road and market:

9. Distance between adjacent farm:

10. Location of industries near by the farm:

• Cement / Chemicals/ Leather / Steel / Textile / Sugar cane / Glass / Others

11. Micro / Macro climatic condition:

• Maximum temperature
• Minimum temperature
• Humidity
• Wind velocity

12. Rain fall details:

• Annual rain fall
• Season

13. Type of farming:

• Single farming / mixed farming / Agriculture / Animal Husbandry / Horticulture / Aquaculture

14. Date of start:

• Agriculture
• Animal Husbandry

15. Categories of livestock:

• Cattle
• Buffalo
• Sheep
• Goat
• Pig
• others
  • Predominant category
  • Breeds particulars

16. Initial source of animal:

17. Introduction of new animals:

18. Breeding particulars:

19. Calving particulars:

20. System of rearing:

• Intensive / Semi-intensive / Extensive

21. Type of shelter:

• Floor space:
• Ventilation:

22. Feeding particulars :

• Type of pasture land:                                            
• Area:
• Pasture land predominantly covered by:
• Green fodder: Level of feeding:
  • Grasses:
  • Cereals:
  • Legumes:
  • Others:
• Dry fodder Level of feeding:
  • Cereals:
  • Legumes:
  • Others:
• Silage: Level of feeding:
• Concentrate: Own preparation / commercial
  • Level of feeding:
  • If commercial source:
  • If own preparation ingredient used source of purchase

23. Watering particulars:

• Open well / Bore well / Tank / River / others
• Treated / Untreated
• Water analysis report

24. Production particulars:

• Average Production
• Drop in production
• Other information

25. Disposal of fecal matter / urine:

26. Consultancy service rendered by:

27. Disease status:

• Disease prevalence
• Mass screening test employed
• Laboratory findings
• Status of endoparasitic infestation
  • Deworming particulars
  • Following schedule or not
  • If following, schedule
  • Dewormer used
• Status of ectoparasitic infestation
  • Measures taken against control of ectoparasites
• Treatment particulars
• Vaccination particulars
  • Vaccines used against
  • Dose & Schedule followed
  • Source of purchase
• Biosecurity measures adopted

28. Other information: