Form XII — Notice of Periods of Work

Rule: Rule 71 · Signed by: Manager · Under: OSH & Working Conditions (Central) Rules 2026

What the form records

Name of the Establishment
Place
District
Periods of work Groups, Relays
Total no. of men employed
Total no. of women employed
Description of Groups, Nature of work
Remarks
On working days - From
On working days - To
On partial working days - From
On partial working days - To
Date on which this notice is first exhibited
Signature of employer
Date

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

MedFactory — Occupational Health Centre software for Indian factories