Factories Act · Form 6
Form 6 — Record of Eye Examination
Workers exposed to processes involving eye risk — periodic eye-sight examination by ophthalmologist. Only the ophthalmologist signs the register; FMO arranges the camp.
Rule: Rule 77(4) · Signed by: Ophthalmologist
Workers exposed to processes involving eye risk — periodic eye-sight examination by ophthalmologist. Only the ophthalmologist signs the register; FMO arranges the camp.
What the form records
- Sl. No.
- Department / Works
- Name of worker
- Sex
- Age (last birthday)
- Occupation (nature + date of employment)
- Eye-sight exam (date + result)
- Signature of ophthalmologist
- Remarks
Blank statutory template. Fill, save and print Form 6 in MedFactory, or view the official layout in the Model Factories Rules gazette.
MedFactoryFill, save and print Form 6.
Open MedFactory →