FORM NO. 28 (Prescribed under Rule 110) MUSTER ROLL

Sl. No.

Serial number in the Register of adult /child worker

Name of worker

Fathers Husbands name

Date of appointment

Group to which the worker belong

Occupation

Alphabet Assigned

Number of relay If working In shift

Adolescent if certified as adult

Period of work

Number & date Of certificate 9

Token number under Section 68 10 11

1

2

3

4

5

6

7

8

Daily attendance for the month of

Total number of mandays worked 13

Man days lost due to Strike 14 Lay off 15 Lockout 16 Leave with pay 17 Leave without pay 18

Any other person

12

19

Total of 1, 15 to Col. 20 20

Number of festival & national holiday 21

Number of weekly holidays (off) paid for 22

Total mandays paid for 23

Remarks 24

* sum of Col. 14 + col. 18 + Col. 22 + Col. 23 + (col. 15 to 17 if paid for).