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				<h5 class='modal-title'>Form 32</h5>
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					<?php 

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					$query = "select company_logo,image_type from company_profile where company_id =5 ";
					//echo $query;
					$result = mysqli_query($conn,$query);
					$row = mysqli_fetch_array($result);
					@extract($row);?>


						<table width="100%" class="tbl4">
                        <tr>
                         <td align="center" style="font-weight:900;">RCCPL PRIVATE LIMITED, BHARAULI (MAIHAR)</td></tr>
                        <tr><td align="center" style="font-weight:900;">MADHYAPRADESH -485773</td> </tr>
                        
							
                    	</table>
				          <hr>
					
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								style="margin-top: 20px; margin-left: 10px; margin-right: 10px" id="form_32_div">
								<table width="100%" id="header_table"><input type="hidden" name="medical_exam_id" id="medical_exam_id"><input type="hidden" name="form_type" id="form_type">

                                    <tr>
                                    <td colspan="2" align="center" style="font-weight:900;">FORM NO- 32</td>
                                    </tr>
									<tr>
										<td colspan="2" align="center">CERTIFICATE OF FITNESS FOR
											HAZARDIOUS PROCESS/DANGERIOUS OPERATION</td>
									</tr>
									<tr>
										<td colspan="2" align="center">[Prescribed under rule 131 &
											Sch.XVII (7)]</td>
									</tr>
									<tr>
										<td colspan="2" align="center">ORIGINAL/COUNTER FOIL</td>
									</tr>
								</table>
								<div style="margin-top: 20px">
									<table width="100%" id="table_body" class="tbl3">
										<tr>
											<td><p contenteditable="true">2. He/She is Medically Fit to be employed but may be employed on some other non-hazardous operation such as..................</p></td>
										</tr>
										<tr>
											<td><p contenteditable="true">3. He/She may be produced for further examination after a period of.......</p></td>
													
										</tr>
										<tr>
											<td><p contenteditable="true">4. He/She is advised following further examination..............................</p></td>
													
										</tr>
										<tr>
											<td><p contenteditable="true">5. He/She is advised following treatment............</p></td>
													
										</tr>

										<tr>
											<td><p contenteditable="true">6. The serial No. Of the previous certificate is..........</p></td>
													
										</tr>
										
										<tr>
										<td align="center" id="valid_date"></td>
										</tr>
									</table>
								</div>
								<div style="margin-top: 100px">
									<table width="100%" class="tbl3"> 
										<tr>
										     <td>Signature / LTI of person examined </td>

											<td align="right"><span align="right" class="profile-picture" id="profile-picture"  >
												
											 </span></br>Digital Signature with Stamp</td>
										</tr>

										<tr>
											<td align="left">Name of Medical assistant</td>
										</tr>

										<tr>
											<td  colspan="2" align="right">( Factory Medical Officer)</td>
											
						                    
						                    
										</tr>
										<tr>
										<td colspan="2" align="right" id="doctor_name"></td>
										</tr>
										<tr>
										<td colspan="2" align="right" id="qualification"></td>
										</tr>
										<tr>
										<td colspan="2" align="right" id="registration_no"></td>
										</tr>
										
									</table>
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