" . $str . ""; return $initial_str . " " . $updated_str; } $sql_form_type_data = "select a.*,b.ticket_no,b.approve_date,b.doc_attend,b.medical_attend,b.fit_unfit_status,b.doc_findings,p.* from form_data a inner join checkup_form b on a.checkup_id=b.checkup_id left join patient_master p on p.id=b.emp_id where a.checkup_id='" . $_REQUEST['checkup_id'] . "'"; error_log("query " . $sql_form_type_data); $result_form_type_data = mysqli_query($conn, $sql_form_type_data); $row_form_type_data = mysqli_fetch_assoc($result_form_type_data); @extract($row_form_type_data); ?>
FORM NO- 33
[Prescribed under Rules 68-T and 102]
Certificate of fitness for employment in hazardous process and operations
(To be issued by Factory Medical Officer)

Signature or left hand thumb impression of the person examined :
Signature of the Factory Medical Officer :


Stamp of factory Medical Officer with Name of the Factory
Date:

I certify that I examined the person mentioned above on (date of examination) I examined this certificate unfit (If certificate is not extended , the period for which the worker is considered unfit for work is to be mentioned) Signs & symptoms observed during examination. Signature of the Factory medical Officer with date.
Notes:
  1. If declared unfit, reference should be made immediately to the Certifying Surgeon.
  2. Certifying Surgeon should communicate his findings to the occupier with 30 days of the receipt of this reference.