Form No.18 (Prescribed under Rule 96) NOTICE OF ACCIDENT OR DANGEROUS OCCURRENCE RESULTING IN DEATH OR BODILY INJURY (To be sent forthwith to the Inspector of Factories) (See Instruction below) This space to be completed by Inspector of Factories District Date of Receipt Number of Accident or dangerous Occurrences Industry No. Causation No. Sex (M.W.B., or G) Other particulars (e.g. fatel, leg injury, arm injury etc.) Date of Investigation Result of Investigation 1. Name of Factory 2. Address of Works where accident or dangerous occurrence happened 3. Nature of Industry 4. Branch or Department and exact place where the accident or dangerous, occurrence happened. 5. Injured person's name and address 6. Fan. (a) Sex (b) Age (last birthday and) (c) Occupation of injured person 7. Date and hour of accident or dangerous occurrence (a) Type. (b) Speed and horse Power. 8. Hour at which he started work on day of accident or dangerous occurrence. 9. (a) Cause or nature of accident or dangerous occurrence (a) (b) If caused by machinery: (i) Give name of the machine and part causing the accident or dangerous occurrence, and (b) (i) (ii) State whether it was moved by mechanical power at the time (b) (ii). (c) State exactly what injured person was doing at the time (e) 10. Nature and extent of injuries (e.g.) fatel, loss of finger, fracture of leg, scald, scratch followed by ............................................... Sepsis .................................................. 11. If accident or dangerous occurrence is not fatel, state whether injured person was disabled for 48 hour or more ............................... 12. Name of medical officers in attendance or injured person. I Certify that to the best of my knowledge and belief the above particulars are correct in every respect. Signature of Occupier or Manage Date of despatch of report Note.- To be completed in legible handwriting or preferably typewritten. EXTRACT FROM THE FACTORIES Act, 1948 Notice Certain Accidents (Section 88) 1. Where in any factory an accident occurs which causes death, or which cause any bodily injury by reason of which the person injured is prevented from working for a period of forty-eight hours or more immediately following the accident, or which is of such nature as may be prescribed in this behalf, the manager of the factory shall send notice thereof to such authorities, and in such form and within such time, as may be prescribed. 2. Where a notice given under sub-section (1) relates to an accident causing death, the authority to whom the notice is sent shall make an inquiry into the occurrence within one month of the receipt of the notice or, if such authority is not the Inspector cause the Inspector, to make an inquiry within the said period 3. The State Government may make rules for regulating the procedure a inquiries under this section. EXTRACT FROM DELHI F ACTORIES, RULES 1950 (Rule 96 prescribed under Sections 38 and 88-A) 1. When any accident which results in the death of any person or which result in such bodily injury to any person as is likely to cause his death or any dangerous occurrence specified in the Schedule takes place in a factory, the manager of the factory shall forthwith send a notice thereof by telephone, special messenger or telegram to the Inspector and the Chief Inspector 2. When any accident or any dangerous occurrence specified in the Schedule, which results in the death of any person or which result in such bodily injury to any person as is likely to cause his death, takes place in a factory, notice as mentioned in sub-rule (i) shall be sent also to :- (a) the District Magistrate or sub-Divisional Officer. (b) the officer-in-charge of the nearest police station, and (c) the relatives of the injured or deceased person. 3. Any notice given as required under sub-rules (1) and {2) shall be confirmed by the manager of the factory to the authorities mentioned in these sub-rules within 12 hours of the accident or the dangerous occurrence by sending the Written report in Form No.18 in the case of an accident or dangerous occurrence causing death or bodily injury to any person and in Form 18-A in the case of dangerous occurrence which has not resulted in any bodily injury to any person. 4. When any accident or dangerous occurrence specified in the Schedule takes place in a factory and it causes such bodily injury to any person as prevents the person injured from working for a period of 48 hours or more immediately following the accident or the dangerous occurrence, as the case may be the manager of the factory shall send a report thereof to the Inspector in Form No.18 within 24 hours after the expiry of 48 hours from the time of the accident or the dangerous occurrence. Provided that if in the case of any accident or dangerous occurrence, death occurs of any person injured by such accident or dangerous occurrence after the notices and reports referred to in the foregoing sub-rules have been sent the manager of the factory shall forthwith send a notice thereof by telephone, special massenger or telegram to the authorities and persons mentioned in sub-rules (1) and (2) and also have this information confirmed in writing within 12 hours of the death. Provided further that, if the period of disability from working for 48 hours or more referred to in sub-rule (4) does not occur immediately following the accident, or the dangerous occurrence, but later on occurs in more than one spell, the report referred to shall be sent to the Inspector in the prescribed form 18 within 24 hours immediately following the hour when the actual total period of disability from working resulting from the accident or the dangerous occurrence becomes 48 hours. SCHEDULE The following classes of dangerous occurrence, whether or not they are attended by personal injury disablement : (a) Bursting of a plant used far containing or supplying steam under pressure greater than atn1ospheric pressure. (b) Collapse or failure of a crane, derrick, which hoist or other appliances used in raising or lowering persons or goods, or any part thereof, or the overturning of a crane. (c) Explosion. fire, bursting out, leakage or escape of any molten metal, or hot liquor or gas causing bodily injury to any person or damage to any room or place in which persons are employed, or fire in rooms of cotton pressing factories when a cotton opener is in use. (d) Explosion of a receiver or container used for the storage at a pressure greater than atmospheric pressure of any gas or gases (including air) or any liquid or. solid resulting from the compression of gas. (e) Collapse or subsidence of any floor, gallery, roof, bridge, tunnel, chemney, wall, building or any other structure. | 
