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Get Form 27 Certificate Of Fitness Rule 95

FORM 27 Prescribed Under Rule 122 Certificate of Fitness for employment in hazardous Processes/dangerous operations To be issued by Certifying Surgeon Serial number in the register of adult workers Name of person examined Father s name Sex Residence Date of birth if available Referred by a Name address of the factory b Name of the manager The worker is proposed to be employ in a Hazardous process b Dangerous operation I certify that I have personally examined the above named person whose identification marks are. and who is desirous of being employed in above mentioned process/ operation and his/her age as nearly as and can be ascertained from by examination is. FORM 27 Prescribed Under Rule 122 Certificate of Fitness for employment in hazardous Processes/dangerous operations To be issued by Certifying Surgeon Serial number in the register of adult workers Name of person examined Father s name Sex Residence Date of birth if available Referred by a Name address of the factory b Name of the manager The worker is proposed to be employ in a Hazardous process b Dangerous operation I certify that I have personally examined the above named person whose identification marks are. and who is desirous of being employed in above mentioned process/ operation and his/her age as nearly as and can be ascertained from by examination is. years and in my opinion he/she is fit/unfit for employment in the said process/operation* He/she is fit to be employed and may be employed in some other nonhazardous operation such as. He/She may be produced for further examination after a period of*. He/She is advised following further examination*. The serial number of the previous certificate is. Signature or left hand thumb Impression of person examined Date Certifying Surgeon examined the person mentioned above on date of examination I extend this certificate until If certificate is not extended the period for which the considered unfit for work is to be mentioned* Signs and symptoms observed during examination Notes - To be issued by the Certifying Surgeon and a copy to be maintained in a bound book or in a file. and who is desirous of being employed in above mentioned process/ operation and his/her age as nearly as and can be ascertained from by examination is. years and in my opinion he/she is fit/unfit for employment in the said process/operation* He/she is fit to be employed and may be employed in some other nonhazardous operation such as. years and in my opinion he/she is fit/unfit for employment in the said process/operation* He/she is fit to be employed and may be employed in some other nonhazardous operation such as. He/She may be produced for further examination after a period of*. He/She is advised following further examination*. He/She may be produced for further examination after a period of*. He/She is advised following further examination*. The serial number of the previous certificate is. Signature or left hand thumb Impression of person examined Date Certifying Surgeon examined the person mentioned above on date of examination I extend this certificate until If certificate is not extended the period for which the considered unfit for work is to be mentioned* Signs and symptoms observed during examination Notes - To be issued by the Certifying Surgeon and a copy to be maintained in a bound book or in a file.

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Keywords relevant to Form 27 Certificate Of Fitness Rule 95

  • unfit
  • Fitness
  • HAZARDOUS
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