FORM No. 28

(Prescribed under Rule 115 (3))

Attendance Card

Name of factory …………………………………………………………………

Serial No.  ……………Department….…………………………………………

Name of work …………………………………………………………………

Father’s or Mother’s name ………………………………………………………

Permanent address ………………………………………………………………

 Local  address .. …………………………………………………………………

 Signature of thumb impression                                   

Date of commencement of 
worker                                                                            employment

 

 

                                                                      *Date of termination of
                                                                                      employment

*Note :- To be entered only when employment is terminated

Entries on the Reverse Side

 Month of  ……………………… 19 …………………...

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

 

 …………………………..

Signature of initials of the Manager or Time Keeper)