Notice Under The Employee’s State Insurance Act, 1948 271 - Legal Draft
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Notice under the Employee’s State Insurance Act, 1948
Certificate of Pregnancy
Maternity Benefit
Certified of Pregnancy
Maternity Benefit
Certified of Pregnancy
Book No.
Serial No.
To
Insurance No.
I Certify that I have examined you today and that in my opinion you are pregnant and your pregnancy appears to be .................... weeks old.
(Signature of Midwife, if any)
(Signature or counter-signature)
of Insurance Medical officer.)
Dated ................20............(Signature or counter-signature)
of Insurance Medical officer.)