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船名/航次:
船名/航次:
质损负责人:
+质损责任方:
+责任人:
Yard staff:
tally clerk:
the ship:
Foreman:
Capt/Chief Mate:
Signature of Foreman:
Capt/Chief Mate:
Foreman:
Capt/Chief Mate:
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Signature of Foreman:
Captain/Chief officer:
Captain/Chief Officer:
Signature of Foreman:
Signature of Duty manger:
Captain/Chief Officer:
Captain/Chief Officer:
Signature of Foreman: