Factories Act · Form 24
Form 24 — Health Register
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.
Rule: Schedules to Rule 19(5) & Rule 120 · Signed by: Authorized Certifying Surgeon · MFR 1963: Form 7
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
Blank statutory template. Fill, save and print Form 24 in MedFactory, or view the official layout in the Model Factories Rules gazette.
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