Shipper (发 货 人) D/R No. (编号) （实际托运人章） Consignee (收 货 人) 场站收据副本 大副联 COPY OF DOCK RECEIPT (FOR CHIEF OFFICER) Notify Party (通 知 人)第 六 联 Received by the Carrier the Total number of containers or otherpackages or units stated below to be transported subject to the terms Pre-carriage by (前程运输) Place of Receipt (收货地点) and conditions of the Carrier's regular form of Bill of Loading (for combined Transport or Port to Port Shipment) Which shall be deemed to be incorporated herein. Date (日期)： Ocean Vessel (船名) Voy. No. (航次) Port of Loading (装货港) 场站章 Final Destination Merchant's Reference Port of Discharge (卸货港) Place of Delivery (交货地点) for the Container No.(集装箱号) Seal No. (封志号)Marks & Nos.(标记与号码)(目的的) Measurement 尺码(立方米) No of King of Package: Description of Goods (包装种类与货名)contai-ners or p'kgs.(箱数或件数) Gross Weight毛重(公斤) TOTAL NUMBER OF CONTAINERSOR PACKAGES (IN WORDS)集装箱数或件数合计(大写) Container No. (箱号) Seal No. (封志号) Pkgs. (件数) Container No. (箱号) Seal No. (封志号) Pkgs. (件数) －DOOR FREIGHT&CHARGESPrepaid at (预付地点)Received (实收) By Terminal clerk (场站员签字) Payable at (到付地点) Place of Issue (签发地点) Total Prepaid (预付总额) No. of Original B(s) /L (正本提单份数) BOOKING (订舱确认)APPROVED BY Service Type on Delivery －CFS Service Type on ReceivingReefer Temperature Required (冷藏温度) －CY －CFS －CY －DOOR ℉ ℃ (普通) Ordinary. Bulk.(散货) Dangerous.(危险) Reefer. (冷藏) Auto. (裸装车辆) TYPE OF GOODS (种类) Liquid. (液体) Class: 危 Property: 险 IMDG Code Page: 品 UN No. Live Animal. (活动物)
