Dogue Death Survey

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1. What is your dog's name?
2. Approximate date of birth
MM DD YYYY
Approximate date of birth:
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3. Date of death:
MM DD YYYY
Date of death:
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4. Sire’s name:
5. Dam’s name:
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6. Age at death:
7. Sex:
8. Mask Color:
9. Has this dog ever produced puppies? If so, approximately how many?
10. Cause of Death: