Apply For New Pet Dog License APPLICANT DETAILS Middle Name Last Name DOB (Not Applicable for below 18 years) APPLICANT ADDRESS Plot/House No. Street Name Pin Code Colony Ward Zone Phone Number (Landline) Mobile Number OTP Email id DOG DETAILS Name of Pet Dog Gender of Pet Dog Male Female Upload Dog Photo In jpeg/jpg format and size should not exceed 20 KB Upload Dog Photograph with owner In jpeg/jpg format and size should not exceed 20 KB) Breed of Dog AFGAN HOUND AKITA ALASKA AMERICAN COCKERS SPANIEL AUSTRALIAN SHEPHERD AUSTRALIAN TERRIER BASSET HOUND BEAGLE BOSTON TERRIER BOXER BULL DOG BULL MASTIFF BULL TERRIER CAVALIER KING CHARLES SPANIEL CHIHUAHUA CHOW CHOW COCKERSPANIEL ENGLISH COLLIE DALMATION DESI BREED DOBERMAN PINSCHER ENGLISH MASTIFF ENGLISH SPRINGER SPANIEL FOX HOUND FOX TERRIER FRENCH BRITTANY SPANIEL FRENCH BULLDOG GERMAN SHEPHERD GERMAN SHORTHAIRED POINTER GOLDEN RETRIEVER GREAT DANE IRISH SETTER LABRADOR RETRIEVER LHASA APSO MALTESE DOG MINIATURE SCHNAUZER NEPOLEON MASTIFF PEMBROKE WELSH CORGI PITBULL TERRIER POMERANIAN POODLE PUG ROTTWEILER SAMOYED SHARPEI SHEEPDOG SHIH TZU SIBERIAN HUSKY SOLUKI SPANISH POINTER SPITZ ST. BERNARD STAFFORD SHIRE TERRIER TIBETAN SPANIEL YORKSHIRE TERRIER Other Age as on date of registration Date of last anti rabies vaccination Valid up to anti-rabies vaccination Vaccination Certificate Number (Max Length 50 Char) Date of Vaccination Certificate Name of veterinary doctor/hospital from where dog got vaccinated Name of council where veterinary doctor is registered Veterinary Doctor Registration number Mobile number of doctor UPLOAD REQUIRED DOCUMENTS Note: A. Enclosures / Attachments Hereby applicant requested to upload self attested copies of all the documents B. For uploading documents max size should be 2 MB and scan copy should be PDF format only ANTI RABIES VACCINATION CERTIFICATE ISSUED BY REGISTERED VETERINARY PRACTITIONER /HOSPITAL APPLICANT ID PROOF APPLICANT RESIDENCE PROOF PHOTOGRAPH OF APPLICANT ALONG WITH PET DOG. Submit
