Login : Advocate | Client
Home Post Your Case My Account Law College Law Library

Employees’ State Insurance (General) Regulations, 1950

FORM 8: First Certificate


[Regulations 57 and 89B]

49 [Signature/thumb-impression of insured person..............................]

50 [Deposit this certificate within 3 days with local office to avoid possible loss of benefit under regulation 64]

Book No ____________

Serial No ___________

51 [Employer's Code No.]

Insurance No _____________                                                      

Stamp of dispensary ________

    I certify that I have examined you today and that in my opinion you now need medical treatment and attendance and abstention from work on medical grounds by reasons of ________

*In my opinion you will be fit to resume work tomorrow / on 52[______________]

Date ____________                                                                                 

Signature ____________

Insurance Medical Officer

(Rubber stamp or name in block letters)

Any other remarks by the Medical Officer ________________________________

Employees'   State Insurance (General) Regulations, 1950 Back

Client Area | Advocate Area | Blogs | About Us | User Agreement | Privacy Policy | Advertise | Media Coverage | Contact Us | Site Map
powered and driven by neosys