To the Health Officer, D. C. 190 
Sir : I have carefully examined the cattle upon the premises above referred 
to, and their condition is as follows : 
Signature 
Address 
Personally appeared before me this day of , 190 , the subscriber, 
who being duly sworn deposes and says that he is a veterinary surgeon, practic- 
ing in accordance with the laws of the State in which he resides, and that he 
has personally examined the cattle referred to in the above statement and knows 
them to be the same as are referred to in the application to which the certificate 
is appended, and that their condition is correctly described without evasion or 
concealment. 
Signature 
Address 
No. 
Health Department, District of Columbia. 
DAIRY PERMIT. 
Permission is hereby granted to maintain a dairy at subject 
to regulations governing dairies within the District of Columbia. 
., 190 
, M. D., 
Health Officer. 
issued in accordance with an “Act to regulate the sale of milk in the District 
of Columbia, and for other purposes,’’ approved March 2, 1895. 
This permit is not transferable, and applies only to the premises specified 
hereon. If location is changed, new permit is required. 
Health Department, District of Columbia. 
No 
DAIRY FARM PERMIT. 
Permission is hereby granted to maintain a dairy farm at 
subject to regulations governing dairy farms within the District of Columbia. 
, M. D., 
Health Officer. 
, 190 
Issued in accordance with an “Act to regulate the sale of milk within the 
District of Columbia, and for other purposes,” approved March 2, 1895. 
This permit is not transferable. 
Health Department, District of Columbia. 
No 
MILK IMPORTER’S PERMIT. 
Permission is hereby granted to bring or send milk into the District 
of Columbia from the dairy farm located at and described in applica- 
tion No. , subject to the following conditions : 
That none but pure and unadulterated milk shall be, with knowledge of its 
impurity, brought into said District. 
That in the management of the dairy farm upon which the milk is produced, 
or at the dairy at which the milk is collected and stored prior to shipment, 
the applicant shall be governed by the regulations of the health office of the 
District of Columbia, approved by the Commissioners of said District, issued 
