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Bare acts > Beedi Workers Welfare Fund Rules, 1978 > Form B
 
  


 

FORM-B:
(See rule 33)
Certificate of Inspection

Inspection Report of the Maternity Centre at …………………….. by the ………….. for the year …………………. ending ………….. 19 .

1. Name of establishment (including factory contractor engaged in the manufacture of the beedi served by the Maternity Centre.

2. Number of workers for which it caters.

3. Date and hour of inspection.

4. Date of last inspection.

5. Maternity Centre buildings-

(a) Condition of Maternity Centre buildings.
(b) Does the accommodation provided conform to the prescribed standard?

6. Medicines-

(a) Is the supply sufficient and according to the prescribed scale?
(b) Are the poisons labelled and kept separately under lock and key ?

7. Surgical instruments and equipments-Are they sufficient and in good order?

8. Staff Acquittance Roll-Are they in order and up to date?

9. Registers and Returns-Are these properly kept and regularly submitted?

10. Establishments-
(a) Officer-in-charge-
(i) Part-time/Whole-time.
(ii) Name and qualifications.

(b) Designation and pay of staff-

(i) Medical Graduate.
(ii) Medical Licentiate.
(iii) Lady Doctor.
(iv) Compounder.
(v) Nurse.
(vi) Midwife.
(vii) Ayah.
(viii) Sweeper.
(ix) Ward Attendant.
(x) Cook.

(c) Attendance Register-Do the staff attends regularly?

11. Annual expenditure on-
(a) Establishment.
(b) Medicines.

12. Out-patients-
(a) Number seen at the time of visit.
(b) Total number of new patients treated in current year up to date.
(c) 1[* * * *]
(d) Total treated during the last year.
(e) Do the entries on tickets of patient present tally with the entries on the register ?

13. Are you satisfied with the working of the Maternity Centre? If not, what suggestions can you make for its improvement?

I certify that I have inspected the Maternity Centre noted above and conforms/ does not confirm in the following respects* to the standards laid down does not conform in the Beedi Workers Welfare Fund Rules, 1978.

Signature of the Inspecting Officer

Date ………………….
Counter-signature of Commissioner

Date……………………

*Give details below,

NOTE. -The countersignature of the Commissioner is not necessary when the Commissioner himself is the Inspecting Authority.

1. The entry “Total number of old patients treated in current year up-to-date” omitted by G S. R. 703, dated 6th August, 1982 (w.e.f. 21st August, 1982).

 

 

 

 

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