Form 24 — Health Register

Rule: Schedules to Rule 19(5) & Rule 120 · Signed by: Authorized Certifying Surgeon · Under: Factories Act 1948 / Model Factories Rules 2020

Longitudinal health record per hazardous-process worker — dates of medical exams, signs/symptoms, tests, declarations of unfitness, re-certification. Each entry signed by Certifying Surgeon only; FMO maintains the underlying clinical data via the 6-Month Health Check module.

What the form records

• Sl. No.
• Department / Works
• Name of worker
• Sex
• Age (last birthday)
• Date of employment on present work
• Date of leaving / transfer with reason
• Nature of job / occupation
• Raw materials, products, by-products likely to be exposed to
• Dates of medical examination + result (fit/unfit)
• Signs and symptoms observed during examination
• Nature of tests and results
• If declared unfit: state period of suspension with reasons
• Whether certificate of unfitness issued
• Re-certified fit to resume duty on
• Signature of Certifying Surgeon with date

This page opens the blank statutory form in MedFactory, ready to fill, save and print. See the Form 24 reference page for the rule and signatory detail.

MedFactory — Occupational Health Centre software for Indian factories