477186-1938-Merchant-Shipping-Ord--1899-Form-for-certificates-of-discharge-of-seamen — Page 3

682

THE HONG KONG GOVERNMENT GAZETTE, SEPTEMBER 16, 1938.

Year of Birth

年某於生

Capacity

業職

Description of Appearance

貌容

Height

高身

Tattoos and Marks

誌秘上身

Address of Nearest Relations

址住之人親至

Harbour Office Stamp

記印府政船

Lifeboatman Certificate No.

數號照執員艇生救

(3rd and following pages)

Steamer

Xo, on

Date and Date and

and dos-

Articles

and

Place of

cription

engage-

Rating.

of

voyage.

ment.

l'lace of General

Dis- charge.

Captain's

Official

Conduct.

Ability. signa-

stamp.

Lure.

COUNCIL CHAMBER,

31st August, 1938.

T. MEGARRY,

Clerk of Councils.