Name and address Name and address of establishment

of Contractor : in/under which contract is carried on

Name and address of Principal employer
Nature and Location of Work: :
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
1 1
RAKESH SINGH
(ESI NO:5900033272)
SSK P P P P P P PH P P P P P P P P P P P P P P P P P P P P 27.0 171.50 4631.00 270.00 4901.00 86.00 588.00 4227.00
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Sig / Thumb
impressin of
workmen
FORM XVIII [See Rule 78 (2) (a)]
FORM OF REGISTER OF WAGES - CUM - MUSTER ROLL
Wages Period : MONTHLY
From : 01/03/2012 To 31/03/2012
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NAME OF WORKMAN /
WOMAN
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Daily attendance units worked
Amount of wages Earned
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1
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5
%
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2
%
Net Amount
paid
intial of contractor
on his
Representative
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time
others cash
payments
Total
230730394.xls.ms_office