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Picture Gallery - 2


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Form for inclusion in the list of vets


         If you want your name to be included in the list of vets, please give your particulars in the form below.  ALL fields are essential.  Submission of incomplete information may result in rejection of application.  



                Name :                                 


               Qualifications :                     


                Address of clinic :                


                State :                                  


                Tel No. (Clinic) :                    


                Tel No. (Residence) :            


                Mobile No. (if any):               


                Email Address :                    


                What kind of animals you treat :


                Do you treat birds? :               


                Do you provide 24 hours emergency service? :     


                Emergency Telephone No. (if any) :   



















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