The Arunachal Pradesh Occupational Safety, Health and Working Conditions Rules, 2022
Form XI
Official text
Open in the official PDF (p. 214)
Tables and forms lose their layout when extracted; the PDF is the authoritative version.
[See Rule-21(5)]
REGISTER FOR LEAVE WITH WAGESL
Part I - Adults
Part II - Adolescents
Establishment: Name of worker:
Department: Father’s Name:
oN .lS
retsiger
eht ni .on.lS
srekrow
fo
ecivres
otni
yrtne fo etaD
Interruptions
morf
tceffe
htiw eud evaeL
eht
gnirud
derised
ton evael
rehtehW
shtnom
21 txen
dewolla
si
rekrow
eht hcihw morf
etaD
evael
doireP
evaeLrof
diaP segaW
Discharged
worker
stnedicca
dna ssenkciS
evaeL
dezirohtuA
ekirtS
lageL ro tuO
kcoL
tnemyolpmenu
yratnulovnI srehtO
egrahcsiD
fo etaD
tnuoma
& etaD
evael
fo
ueil
ni edam tnemyap
fo
eud
skrameR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Note:- Separate page shall be allotted to each worker