Form v
(See Standing Order I, Schedule I-B)
Service Card
Name of Estt./Factory/
Ticket /Token No.
1. Register Serial No.
2. Name
3. Specimen Signature/Thumb Impression.
4. Father's or Husband's name
5. Sex
6. Religion
7. Date of Birth
8. Place of Birth
9. Date of Joining
10. Details of Medical certificate at the time of joining
11. Educational and other qualifications
12. Can Read
13. Can Write
14. Can Speak
15. Height
16. Identification Marks
17 Category of Workman
18. Department
19. Details of family members
20. Permanent Address
21. Local Address
22. Quarter No.
23. Life Insurance Policy No.
24. Provident Fund Account No.
25. Nominee for Gratuity
26. Nominee for pension, if any
27. Employees State Insurance No.
28. Training courses attended (details)
29. (Eligibility for higher jobs)
30. Proficiency tests passed.
31. EMPLOYMENT HISTORY
Department Token No. Designation Scale of Pay Joined Left ( Reason) 1 2 3 4 5 6 |
32. ABSENCE PERIODS
Form To Reason Medical reports regarding suitability for continued employment |
(i) Sick Leave
(ii) Earned Leave
(iii) Any other Leave
33. Maternity Benefit
34. Workmen's Compensation
Details of accidents :
35. Details of Disciplinary Action
36. Promotions
(i) Details
(ii) Awards
(iii) Issue of Certificate of commendation
37. Date of superannuation
38. Any other matter.
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