623 
No Dairy Date 
Distributer Collected by 
Sealing Date of milking 
Hour collected Cultures made Temperature when examined °F. 
General condition : Color Odor ...... Taste 
Separation of cream Macroscopic sediment 
Bacteriologic examination: Media 
Temperature Dilution 
Bacteria per c. c Average 
Pathogenic bacteria 
Microscopic examination, blood, pus, tubercle bacilli, etc 
The examination recorded above, made at the request of The Milk Commission 
of the city of Cleveland, shows a 
by the commission. 
[milk 1 
{cream] 
reaching the bacteriological standard adopted 
Signed 
, Bacteriologist. 
[The foregoing card is printed on light blue paper,] 
It is generally believed that the bacteriological examination should 
be repeated once a week, the chemical examination once a month, 
and the veterinary inspection once a month — the tuberculin test to 
be used on every new cow added to the herd and reapplied at least 
once a year. 
Inquiry is also made, usually by a member of the commission 
regarding the health of employees, and in addition, the dairyman is, 
in certain instances required to render a regular report regarding the 
presence or absence of communicable diseases among the dairy per- 
sonnel. The following form is used at Cleveland, Ohio, for this 
purpose : 
For the information of The Milk Commission, I hereby answer the following ques- 
tions for the week ending , 19 . * 
I. Are any of the men handling milk at your farm ill with any communicable dis- 
ease? 
II. Is there any communicable disease in the families with which they are con- 
nected? 
III. Have any been in contact with any communicable disease and then excluded 
from the milking place? 
IV. Shipments of certified milk and cream in past week: 
(a) Quarts of certified milk (b) Pints of certified cream 
(c) Bottles of certified milk (d) Bottles of certified cream 
V. How many unbroken boxes of caps have you? 
Signed 
Upon these reports the commission bases its action in respect to 
certification and the certificates are renewed once a month. 
The dairyman is thus authorized to indicate such indorsement, 
either by using on his bottle a cap bearing the name of the Medical 
Milk Commission and the term “certified milk” or a copy of the 
certificate. 
