What information on the hours of rest record should be completed on board, as shown in the specimen at Annex B of MSN 1767?

Name of ship; IMO number; Flag; Seafarer (full name); Position/rank; Month and year; Whether a watchkeeper or not; Hours of rest (marked with an X or using a continuous line or an arrow); (Total) hours of rest in 24-hour period; Comments; Master or authorised person's signature; Seafarer's signature.