ESIC form no 32

Can you plz tell from where should I get the ESIC form no 32?

[Pathak]

You were searching for the ESIC form no 32, so for this I am sharing the information with you:

Employees State Insurance Corporation
WAGE/CONTRIBUTORY RECORD FOR DIABLEMENT BENEFIT
1. Name of injured person............................................ .................................................. .......................................
2. Local Office to which attached .................................................. .................................................. ......................
3. Date of entry .................................................. ......... 4. Date of injury............................................ .................
5. Name and Address of employer .................................................. .................................................. ........................
.................................................. .................................................. .....................
6. Department .................................................. ............... Address .


For complete application form, download the PDF file provided below: