Rule Form XIX Form XIX
- Chapter
- Annexures · Forms and Appendices
- Text as on
- As notified 08 May 2026
FORM-XIX (See rule 75) REGISTER OF ACCIDENTS AND DANGEROUS OCCURRENCES
Name of Date of Date of report Nature of Date of return of Number of days Signature of to Inspector- accident injured person the injured employer/repres injured/deceas accident or cum- or dangerous to work person was entative Facilitator occurrence absent from ed person dangerous work
(if any) occurrence
1 2 3 4 5 6 7