how to write to the stock and transfer book?

-what information is needed?

please make a example based on the attachment

attached herewith is the book to be write on.

12 of mo. CERTIFICATE CANCELLED DATE BY WHOM SURRENDERED Ledger No. No. CERTIFICATE ISSUED Folio Certificate Shares LEFT BY IN WHOSE NAME SIGNATURE Ledger No. No. Total No. Subject to By-laws of Company Folio Certificate Shares Shares F5 JOURNAL 6 G U