Form 35 – Record of Eye Examination

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Form 35 – Record of Eye Examination

Form 35 is a statutory register maintained to record periodic eye examinations of workers employed in occupations where vision monitoring is required. The register documents employee details, occupation, employment information, eye examination results, and certification by an ophthalmologist to ensure workers are medically fit for their assigned duties.

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

From the document

FORM 35 (Prescribed under Sub Rule (4) of Rule 65 (L)) Record of Eye Examination Occupation Examination Of eye sight SL NO Dept / work Name of worker S e x Age on last birth day Nature Date of Employment Dat e Result Signature of Ophthalmolo gist Remarks (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)

form 35 · record of eye examination · eye examination register · vision screening · occupational health · eye health monitoring · ophthalmologist report · medical surveillance · worker health monitoring · vision test record

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