Form 18 – Notice of Poisoning or Disease

PDF · 1 pages · English · Acts & Rules

Form 18 is a statutory notification form used for reporting cases of occupational poisoning, industrial diseases, or work-related health conditions occurring in a factory or workplace. The form records details of the affected worker, nature of poisoning or disease, occupation, factory information, and reporting status to the Certifying Surgeon or competent authority.

By Labour Department / Chief Inspector of Factories / Occupational Safety & Health Authority · Published 2026-11-02 · Updated 2026-11-02

From the document

FORM – 18 (Prescribed under rule 107) (To be filled in by the Chief Inspector) Number of Case: Remarks: Notice of Poisoning or disease Factory particulars __ 1. Name of Factory __ 2. Address of factory __ 3. Address of office or private residence __ of occupier 4. Nature of Industry __ Person affected: 5. Name and work number of patient __ 6. Address of patient __ 7. Sex and age of patient __ 8. Precise occupation of patient __ 9. Nature of poisoning or disease from, __ which patient is suffering General particulars __ 10. Has the case been reported to the Certifying surgeon? Date: Signature of Factory Manager

form 18 · notice of poisoning or disease · occupational disease report · industrial disease reporting · workplace illness · occupational poisoning · employee health monitoring · occupational health · industrial health · medical surveillance

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