Form 12 (Prescribed Under Rule 107) - Register Of Adult Workers

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FORM -12
Prescribed under Rule 107
Register of adult workers
Sl.
Name
Date
Sex
Residen
Father’s/
Date of
Group to which
Number
Adolescent if
Remarks
No
of
tial
Husband’s
appoint
worker belongs
of relay
certified as adult
birth
address
name
ment
if
Alphabet
Nature
Number
Number
working
Assigned
of
& date of
under
work
in
certificate
section
shifts
of fitness
68
1
2
3
4
5
6
7
8
9
10
11
12
13

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