श्रम आयुक्त 
(PRESCRIBED UNDER RULE 104)
REGISTER OF ACCIDENTS AND DANGEROUS OCCURRENCES
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Name of injured persons (if any) |
Date of accident or dangerous occurrence |
Date of report (in Form No.18) to Inspector |
Nature of accident or dangerous occurrence |
Date of return of injured person to work |
No. of days injured person was absent from work |
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1 |
2 |
3 |
4 |
5 |
6 |
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