OSH Code · Form XIX
Form XIX — Register of Accidents and Dangerous Occurrences
Form XIX of the OSH & Working Conditions (Central) Rules 2026, prescribed under Rule 75.
Rule: Rule 75 · Signed by: Manager, Safety Officer
Register columns
- Name of injured/deceased person (if any)
- Date of accident or dangerous occurrence
- Date of report to Inspector-cum-Facilitator
- Nature of accident or dangerous occurrence
- Date of return of injured person to work
- Number of days the injured person was absent from work
- Signature of employer/representative
Part of the Seventh Schedule to the OSH & Working Conditions (Central) Rules 2026. View the official form layout in the gazette, or open the OSH Code forms in MedFactory.
MedFactoryOpen the OSH Code statutory forms.
Open MedFactory →