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Union of India - Section

Section 16 in Rationalisation of Forms and Reports under Certain Labour Laws Rules, 2017

16. Designation:

Seal and Signature of Contractor* Please strike off whichever is not applicable.Form IX[Under rule 223(C) of the Building and Other Construction Workers' (Regulation of Employment and Conditions of Service) Central Rules, 1998]Certificate of Medical Examination
1. Certificate Serial No. ................. Date.....................
2. Name :....................................................................
  Identification marks :(1) ........................ (2) ........................
  (i) UAN/Aadhaar No. : .......................................
  (ii) Mobile no. : .......................................
3. Name of father/husband. : .......................................
4. Sex :.......................................
5. Date of birth : ....................... or age :.............................
6. Physical Fitness : ...............................................
I hereby certify that I have personally examined the above named person, son/daughter/wife of....................residing at.................who is desirous of being employed in building and construction work and that his/her age as nearly as can be as certained from my examination is................year and that he/she is fit for employment in ...............as an adult/adolescent.