Form No. 12
(Prescribed under Rule 80)
Register of Adult Workers
Number and date of Certificate, if an adolesent
Serial No.
Name
Father’s Name
Residential Address
Nature of Work
Letter of group as in Form No.
Number of relay, if working in shifts
Number of Certificate and Date
Token Number giving reference to the Certificate
Remarks
1
2
3
4
5
6
7
8
9
10
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