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8th February 2013, 10:32 AM
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Join Date: May 2012
Re: ESIC form no 32

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:
Attached Files
File Type: pdf ESIC form no 32.pdf (47.6 KB, 630 views)


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