Section 21 in Maternity Benefit (Mines and Circus) Rules, 1963
21. Remarks column for the use of the Inspector.
Form B[See Rule 4(1)]This is to certify that I examined.... wife/ daughter of ..... a woman employee in...... (name of [mine or circus] [Substituted by G.S.R. 59(E), dated 27-02-1975 (w.e.f. 1-3-1975).]) on...... (date) and found/cannot discover that she is pregnant and is expected to be delivered of a child within (month and/days) from the above mentioned date/ has undergone miscarriage/[Medical termination of pregnancy or tubectomy operation] [Inserted by G.S.R. 70(E), dated 31-1-1996 (w.e.f. 1-2-1996).]/has been delivered of a child on......... (date) or is suffering from.........(date) from illness arising out of pregnancy/delivery/ premature birth of a child or miscarriage/[Medical termination of pregnancy or tubectomy operation ]. [Substituted by G.S.R. 59(E), dated 27-02-1975 (w.e.f. 1-3-1975).]Signature, qualifications and designation of Medical Officer/Medical PractitionerDate......................................Definitions of "child" and "miscarriage" as in the Maternity Benefit Act, 1961.-
