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INCIDENT/BITE REPORT

  1. Who was bitten/exposed?*
  2. BITE VICTIM INFORMATION
  3. SKIN BROKEN?
  4. BITTEN THROUGH CLOTHING?
  5. ANTI-RABIES PROPHYLAXIS GIVEN?
  6. RABIES VACCINATION?
  7. ANIMAL CURRENTLY ALIVE?
  8. BITING ANIMAL INFORMATION
  9. STATUS*
  10. SEX
  11. RABIES VACCINATION?
  12. ANIMAL CURRENTLY ALIVE?
  13. Leave This Blank:

  14. This field is not part of the form submission.