The Occupational Safety, Health and Working Conditions (Bihar) Rules, 2026
Form XI
Official text
Open in the official PDF (p. 388)
Tables and forms lose their layout when extracted; the PDF is the authoritative version.
[See Rule-31(1)]
REGISTER FOR LEAVE WITH WAGES
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
tceffe
htiw
eud
evaeL morf
gnirud
deriseD
ton
evael
rehtehW
shtnom
21
txen
eht
si
rekrow
eht
hcihw
morf
etaD
evael
dewolla
ni
diaP
evaeL
rof
segaW
Discharged
worker
stnedicca
dna
ssenkciS
evaeL
dezirohtuA
ekirtS
lageL
ro tuO
kcoL
yratnulovnI
tnemyolpmenu
srehtO
egrahcsiD
fo etaD
tnemyap
fo
tnuoma
& etaD
eud
evael
fo ueil
ni edam
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