FORM No.

11
[See Rule 112]

REGISTER OF ADULT WORKERS

year July/Month: Dec-2015 to Dec-2015

Sl.

Name and Residential address of

the worker

Fathers Name

Nature of work and Department

Symbol

Relay assigned
and date of
effect

Certificate of
adolescent

No. of
Certificate and
date
1

Sl.

Name and Residential address of

the worker

Fathers Name

Nature of work and Department

Symbol

5
Relay assigned
and date of
effect

Sl.

Name and Residential address of

the worker

Sl.

2
Name and Residential address of
the worker

Fathers Name

Nature of work and Department

Symbol

Relay assigned
and date of
effect

Certificate of
adolescent

Fathers Name

Nature of work and Department

Symbol

Relay assigned
and date of
effect

Certificate of
adolescent

No. of
Certificate and
date
1

Token number
giving
reference to
the certificate

No. of
Certificate and
date
6

Token number
giving
reference to
the certificate
7

Token number
giving
reference to
the certificate
7

Certificate of
adolescent

No. of
Certificate and
date
6

Token number
giving
reference to
the certificate
7

Date of first
Employment in
the Factory

8
Date of first
Employment in
the Factory

Remarks

9
Remarks

Date of first
Employment in
the Factory

Remarks

Date of first
Employment in
the Factory

Remarks