‫ﻭﺛــﻴــﻘــــﺔ ﺍﻟــﻨــﻘـــــﻞ ‪Transport Document‬‬

‫ﺑـﻴـــﺎﻥ ﺗـﺨـﺮﻳــﺞ ﺷـﺎﺣـﻨــﺔ‬

‫‪Document NO‬‬ ‫‪R00203‬‬ ‫ﺭﻗﻢ ﺍﻟﻮﺛﻴﻘﺔ‬ ‫‪Date‬‬ ‫‪2024/01/21‬‬ ‫ﺍﻟﺘﺎﺭﻳﺦ‬
‫‪Copy NO‬‬ ‫‪2‬‬ ‫ﻋﺪﺩ ﺍﻟﻨﺴﺦ‬ ‫‪Place of issue‬‬ ‫ﺍﻟﻔﺮﻉ ﺍﻟﺮﺋﻴﺴﻲ‬ ‫ﻣﻜﺎﻥ ﺍﻹﺻﺪﺍﺭ‬
‫‪Freight‬‬ ‫ﻋﻠﻰ ﺣﺴﺐ ﺍﻹﺗﻔﺎﻕ‬ ‫ﺃﺟﺮﺓ ﺍﻟﻨﻘﻞ‬ ‫‪Time‬‬ ‫‪03:11‬‬ ‫ﻭﻗﺖ ﺍﻹﺻﺪﺍﺭ‬
‫‪Transporter‬‬ ‫ﺍﻟﻨﺎﻗﻞ‬ ‫ﺧﻂ ﺳﻴﺮ ﺍﻟﺮﺣﻠﺔ ‪Goods Route‬‬
‫‪Name‬‬ ‫ﺷﺮﻛﺔ ﺍﻟﺼﻘﺮ ﺍﻟﺬﻫﺒﻲ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﻠﻮﺟﺴﺘﻴﺔ‬ ‫ﺍﻻﺳــﻢ‬ ‫‪Truck NO‬‬ ‫‪XZX3943‬‬ ‫ﺭﻗﻢ ﺍﻟﺴﻴﺎﺭﺓ‬
‫‪Address‬‬ ‫ﺍﻟﺮﻳﺎﺽ ‪ -‬ﺣﻲ ﺍﻟﻤﺮﺑﻊ ‪ -‬ﻣﺮﻛﺰ ﺍﻟﻮﺷﻢ ﺍﻟﺘﺠﺎﺭﻱ‬ ‫ﺍﻟﻌﻨﻮﺍﻥ‬ ‫‪Shipping Point‬‬ ‫‪RIYADH‬‬ ‫ﻣﻜﺎﻥ ﺍﻟﺸﺤﻦ‬
‫‪Mobile‬‬ ‫ﺟﻮﺍﻝ‬ ‫‪Destination‬‬ ‫‪RIYADH‬‬ ‫ﻣﻜﺎﻥ ﺍﻟﻮﺻﻮﻝ‬
‫‪Tel‬‬ ‫‪4552144-011‬‬ ‫ﻫﺎﺗﻒ‬ ‫‪N Sales Order‬‬ ‫ﺭﻗﻢ ﺍﻟﻄﻠﺐ‬
‫‪Licence NO‬‬ ‫‪1140101421‬‬ ‫ﺭﻗﻢ ﺍﻟﺘﺮﺧﻴﺺ‬

‫‪Sender‬‬ ‫ﺍﻟﻤﺮﺳﻞ‬ ‫ﺍﻟﻤﺮﺳﻞ ﺇﻟﻴﻪ ‪Consignee‬‬

‫‪Name‬‬ ‫‪Al Jazeera Pharmaceutical Indus‬‬ ‫ﺍﻻﺳــﻢ‬ ‫‪Name‬‬ ‫‪----‬‬ ‫ﺍﻻﺳــﻢ‬
‫‪Address‬‬ ‫‪Riyadh‬‬ ‫ﺍﻟﻌﻨﻮﺍﻥ‬ ‫‪Address‬‬ ‫ﺍﻟﻌﻨﻮﺍﻥ‬
‫‪Mobile‬‬ ‫ﺟﻮﺍﻝ‬ ‫‪Mobile‬‬ ‫ﺟﻮﺍﻝ‬
‫‪Tel‬‬ ‫ﻫﺎﺗﻒ‬ ‫‪Tel‬‬ ‫ﻫﺎﺗﻒ‬
‫‪Cargo‬‬ ‫ﺍﻟﺒﻀﺎﻋﺔ‬
‫‪Temperature‬‬ ‫ﺩﺭﺟﺔ ﺍﻟﺤﺮﺍﺭﺓ‬
‫‪Back Seal NO‬‬ ‫‪A/N‬‬ ‫ﺭﻗﻢ ﺍﻟﻘﻔﻞ ﺍﻟﺨﻠﻔﻲ‬
‫‪Drivers Data‬‬ ‫ﺑﻴﺎﻧﺎﺕ ﺍﻟﺴﺎﺋﻘﻴﻦ‬
‫ﺗﻮﻗﻴــﻊ ﺍﻟﺴﺎﺋــــــــﻖ‬ ‫ﺭﻗﻢ ﺍﻟﺠﻮﺍﻝ‬ ‫ﺍﺳـــــﻢ ﺍﻟﺴﺎﺋــــــــﻖ‬ ‫ﺭﻗﻢ ﺍﻟﻬﻮﻳﺔ‬ ‫ﻡ‬
‫‪Driver Signuture‬‬ ‫‪Mobile NO‬‬ ‫‪Driver Name‬‬ ‫‪ID NO‬‬ ‫‪SR‬‬
‫‪0537705341‬‬ ‫‪JASEM MOHAMED AL NWAF‬‬ ‫‪2300777303‬‬ ‫‪1‬‬

‫ﻣﺸﺮﻑ ﺗﺤﻤﻴﻞ ﺷﺮﻛﺔ ﺍﻟﺼﻘﺮ ﺍﻟﺬﻫﺒﻲ‬

‫‪Golden Falcon Loading Supervisor‬‬
‫‪Name‬‬ ‫‪Ahmed Obid‬‬ ‫ﺍﻻﺳــﻢ‬
‫‪Signature‬‬ ‫ﺍﻟﺘﻮﻗﻴﻊ‬

‫‪Approval of receipt of goods‬‬ ‫‪ Notes on receipt‬ﺇﻗﺮﺍﺭ ﺇﺳﺘﻼﻡ ﺑﻀﺎﻋﺔ‬ ‫ﻣﻼﺣﻈﺎﺕ ﻋﻠﻰ ﺍﻹﺳﺘﻼﻡ‬
‫ﻧﻘﺮ ﺃﻧﻨﺎ ﺍﺳﺘﻠﻤﻨﺎ ﺍﻟﺒﻀﺎﻋﺔ ﺍﻟﻤﻮﺿﺤﺔ ﻓﻲ ﻫﺬﻩ ﺍﻟﺒﻮﻟﻴﺼﺔ ﻛﺎﻣﻠﺔ ﻭﺳﻠﻴﻤﺔ ﻭﻧﺼﺮﺡ ﺃﻥ‬
‫ﺍﻟﺸﺎﺣﻨﺔ ﻭﺻﻠﺖ ﺍﻟﻰ ﺍﻟﻤﻮﻗﻊ ﺍﻟﻤﺤﺪﺩ ﻟﻬﺎ ﻭﺗﻢ ﺍﻟﺘﻔﺮﻳﻎ ﻓﻲ ﺍﻟﻮﻗﺖ ﻭﺍﻟﺘﺎﺭﻳﺦ ﺍﻟﻤﻮﺿﺢ‬
‫ﺃﺩﻧﺎﻩ‬
‫‪We acknowledge that we have received the goods‬‬
‫‪described in this policy in full and in good faith and‬‬
‫‪declare that the truck arrived at the specified location‬‬
‫‪and unloaded in the time and date shown below‬‬

‫‪Arrival Date‬‬ ‫ﺗﺎﺭﻳﺦ ﺍﻟﻮﺻﻮﻝ‬

‫‪Arrival Time‬‬ ‫ﻭﻗﺖ ﺍﻟﻮﺻﻮﻝ‬
‫‪Offloading Completion Time‬‬ ‫ﺇﻧﺘﻬﺎﺀ ﺍﻟﺘﻔﺮﻳﻎ‬
‫‪Recipient Name‬‬ ‫ﺍﺳﻢ ﺍﻟﻤﺴﺘﻠﻢ‬