The Mizoram Occupational Safety, Health and Working Conditions Rules, 2026
Form XIV
Official text
Open in the official PDF (p. 216)
Tables and forms lose their layout when extracted; the PDF is the authoritative version.
(See rule-32(1)(c))
REGISTER FOR LEAVE WITH WAGES
Part I – Adult
Part II - Adolescents Establishment:
Name of worker :
Department :
Father’s Name:
oN
.lS
srekrow
fo
retsiger
eht
nI
ecivres
ot
ni
yrtne
fo
etaD
Interruptions
morf
tceffe
htiw
evaeL
gnirud
derised
ton
evael
rehtehW
htnom
21
txen
eht
si
rekrow
eht
hcihw
morf
etaD
evael
dewolla
ni
diap
evael
rof
segaW
Discharge
worker
stnedicca
dna
ssenkciS
evaeL
dezirohtuA
ekirtS
lageL
ro
tuokcoL
tnemyolpmenu
yratnulovnI
rehtO
egrahcsid
fo
etaD
stnemyap
fo
tnuoma&
etaD
eud
evael
eht
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.