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Form No. 11(b)

(Prescribed under Rule 76)

Notice of Periods of Work For Adult Workers

Name of Factory ………………… Place ……………………….. District …………..

Period of Work	Men																Women															Description of groups
Groups	Total number of men employed																Total number of women employed															Group letter	Nature of Work	Remarks
Groups	A			B				C			D			E			F			G			H			I			J
Relays	1	2	3		1	2	3	1	2	3	1	2	3	1	2	3	1	2	3	1	2	3	1	2	3	1	2	3	1	2	3
On working day ;-																																A

From

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From

On partial working days;-

From

Dated on which notice first exhibited …………………………………………..

(signed) ………………………………………….