Form 16A – Health Register
PDF · 1 pages · English · Acts & Rules
Form 16A is a statutory Health Register maintained for monitoring the health status of workers employed in specific occupations, processes, or departments that may expose them to occupational hazards. The register records employment details, job nature, materials handled, periodic medical examination results, symptoms observed, and certification by a Registered Medical Practitioner.
By Labour Department / Occupational Safety & Health Authority · Published 2026-11-02 · Updated 2026-11-02
From the document
FORM – 16 A (Prescribed under rule 16) Health Register SI No Dept / Works Name of the Worker Age at last Birth - day Date of employm ent in present work Date of leaving or Transfer (with reasons for discharge or transfer) Nature of Job on occupation Raw materials / by products handled Date of weekly exams with results (fit / unfit) Nature of Symptoms Signature of a Reg. medical Practitioner (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
form 16a · health register · occupational health register · medical surveillance register · employee health record · worker health monitoring · occupational disease prevention · industrial health · workplace health · health examination register
Read Form 16A – Health Register online
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