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FORM V

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.