Start for free
Agriculture · Form

Sample Form: ثبت سلامت دام

دامدار یا دامپزشک: شماره دام، علائم، دما، واکسن و درمان.

7 questions · Free up to 50 responses a month

Build a form from this templateDownload WordDownload PDFAll templates

Print-ready Word and PDF files — free, no sign-up.

About this template

“ثبت سلامت دام” has 7 questions; 3 are required and 4 optional. Question types: Short text (2), Dropdown (1), Date (1), Decimal (1), Multiple choice (1), Long text (1). 10 ready-made options across 2 choice questions, all editable in the online version.

In the online version of this template

  • Dates are picked and stored on the Jalali (Persian) calendar.
Related:Online form builder

Questions in this template

  1. 1.

    شماره دام / پلاک گوش *

    (Short text)
  2. 2.

    نوع *

    (Dropdown)
    • گاو
    • گوسفند
    • بز
    • مرغ
    • اسب
  3. 3.

    تاریخ *

    (Date)
  4. 4.

    دمای بدن

    (Decimal)
  5. 5.

    علائم

    (Multiple choice)
    • بی‌اشتهایی
    • لنگش
    • اسهال
    • سرفه
    • تب
  6. 6.

    واکسن / دارو

    (Short text)
  7. 7.

    یادداشت

    (Long text)

Printable or online?

Printable version (Word & PDF)

  • For filling in on paper, signing and filing by hand
  • Edit the Word file any way you like
  • Collecting and typing up the answers is up to you
Download WordDownload PDF

Online version on Porsino

  • Answers are collected and organised automatically — no retyping
  • National ID, mobile number and dates are validated instantly
  • Ready-made reports and charts, plus Excel export in one click
  • Share a link or QR code — it works on mobile too
Build the online version for free

How do I use this template?

  1. Sign up for Porsino for free; no bank card needed.
  2. In the panel, open “Templates” and choose “ثبت سلامت دام”.
  3. Change the questions as you like, publish the form and send the link.

Related Agriculture templates

All Agriculture templates