The Occupational Safety, Health and Working Conditions (Lakshadweep) Rules, 2025
Form 17
Official text
Open in the official PDF (p. 239)
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[See Rule-43]
REGISTER FOR LEAVE WITH WAGES
Part I - Adults
Part II - Adolescents
Establishment: Name of worker:
Department: Father’s Name:
Sl. Sl.no. in Date Interruptions Lea Whether Date Wag Dischar Re
No the register of ve leave not from es ged m
of workers entry due desired which for worker ark
into with during the Leav s
Sicknes Authoriz Lock Involuntary Other Date of Date
servi effe the next worker e
s and ed Leave Out unemploym s Dischar &
ce ct 12 is Paid
accident or ent ge amou
from months allowed in
s Lega nt
leave
l of
Strik payment
e made in
lieu of
leave
due
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Note:- Separate page shall be allotted to each worker