None - FORM 16 - HEALTH REGISTER
None - FORM 16 - HEALTH REGISTER
Sl. No
2
Department/Works
3
Name of Worker
Name of the Factory :
4
Sex
5
Age (at last birth day)
6
workDate of employment on present
7
transfer
work-with reasons for discharge or
1
8
Nature of job or occupation
9
likely to be exposed toRaw materials products or by-products
[FORM No. 16
10
Dates
HEALTH REGISTER
11
Unit
Fit or
Dates of medical
examination and
the results thereof
Results
12
13
reasons in detail
15