Příloha č. 5
Záznam proškolené osoby o vyšetření ulovené volně žijící zvěře,
proškolená osoba ev. č. .......... (strana ...../a)
+----------+---------+--------------------+--------+-------------------------------------------------------------------------------+----------------+-----------+----------------------------+
| | | | | Druh a počet ulovené a vyšetřené zvěře | | | Datum a výsledek vyšetření |
| | | Místo ulovení | +--------+----------+------+--------+-------+--------+-------+--------+---------+ | Vyšetření +-----------+---------+------+
| | Datum, | (honitba + okres), | | | | | | | | | | Ostatní | Místo dodání | na | | | |
| Pořadové | doba | jméno a příjmení | Číslo | Prase | Jelen | | | | | | | (slovní | zvěře | svalovce | datum | se | beze |
| číslo | ulovení | lovce | plomby | divoké | evropský | Srna | Muflon | Daněk | Bažant | Zajíc | Kachna | uvedení | | | vyšetření | změnami | změn |
| | | | | | | | | | | | | druhu) | | | | | |
+----------+---------+--------------------+--------+--------+----------+------+--------+-------+--------+-------+--------+---------+----------------+-----------+-----------+---------+------+
| Přenos | | | | | | | | | | | | | | | |
+----------+---------+--------------------+--------+--------+----------+------+--------+-------+--------+-------+--------+---------+----------------+-----------+-----------+---------+------+
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+----------+---------+--------------------+--------+--------+----------+------+--------+-------+--------+-------+--------+---------+----------------+-----------+-----------+---------+------+
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+----------+---------+--------------------+--------+--------+----------+------+--------+-------+--------+-------+--------+---------+----------------+-----------+-----------+---------+------+
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+----------+---------+--------------------+--------+--------+----------+------+--------+-------+--------+-------+--------+---------+----------------+-----------+-----------+---------+------+
| Součet | | | | | | | | | | | | |
| | | | | | | | | | | | | |
+--------------------------------------------------+--------+----------+------+--------+-------+--------+-------+--------+---------+----------------+-----------+----------------------------+
Záznam proškolené osoby o vyšetření ulovené volně žijící zvěře,
proškolená osoba ev. č. .......... (strana ...../b)
+------------------------------------------------------------------------------------------------------------------------------------+---------------------------------+--------+
| Vyšetření se změnami | Poznámky k vyšetření se změnami | Podpis |
+--------+---------+----------+-------+-------+-------+-------+-------------+--------+---------+---------+---------+--------+--------+---------------------------------+--------+
| | | | | | | | | | | | | | Hrudní | | |
| Číslo | Výživný | Osrstění | | | | | Žaludek | Střeva | | | Děloha | | a | | |
| plomby | stav | /opeření | Hlava | Plíce | Srdce | Játra | a | a | Slezina | Ledviny | (plod)/ | Kloaka | břišní | | |
| | | | | | | | předžaludky | okruží | | | varlata | | dutina | | |
+--------+---------+----------+-------+-------+-------+-------+-------------+--------+---------+---------+---------+--------+--------+---------------------------------+--------+
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+--------+---------+----------+-------+-------+-------+-------+-------------+--------+---------+---------+---------+--------+--------+---------------------------------+--------+
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+--------+---------+----------+-------+-------+-------+-------+-------------+--------+---------+---------+---------+--------+--------+---------------------------------+--------+
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+--------+---------+----------+-------+-------+-------+-------+-------------+--------+---------+---------+---------+--------+--------+---------------------------------+--------+
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+--------+---------+----------+-------+-------+-------+-------+-------------+--------+---------+---------+---------+--------+--------+---------------------------------+--------+
| Součet | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | |
+------------------+----------+-------+-------+-------+-------+-------------+--------+---------+---------+---------+--------+--------+---------------------------------+--------+
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