Section 21 in The M.P. Maternity Benefit Rules, 1965
21. Remarks column for the use of the Inspector.
(Note. - One complete page may be allotted to each woman)Form B[See Rule 4]Notice Under Section 6 of the Maternity Benefit Act, 1961(Name of Establishment)I, .........(name of woman) wife/daughter of .......... employed as ..... at ........ (establishment), hereby give notice that I expect to be confined within six weeks next following from the date of this notice/have given birth to a child on .......(date). I shall not work in any establishment during the period for which receive maternity benefit.
