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(a) Upon immunizing an animal for rabies, a licensed veterinarian shall record on a rabies vaccination certificate form approved by the State Division of Public Health, in triplicate, the following:

(1) The name and address of the owner of the animal;

(2) The name, age, sex, breed, and color of the animal;

(3) The date of the immunization;

(4) The type of vaccine used; and,

(5) The name and signature of the veterinarian performing the immunization.

(b) The veterinarian shall give the original copy of the form to the owner of the animal, and may retain the second copy.

(c) The City may supply licensed veterinarians with the forms described in subsection (a) of this section.