The Basics

What is Form 17?

Form 17 is the Health Register prescribed by the Assam Factories Rules, 1950, framed under the Factories Act, 1948 and enforced by the Office of the Chief Inspector of Factories, Government of Assam. Rule 14 (Duties of Certifying Surgeon): at visits to factories carrying on dangerous operations the Certifying Surgeon examines the persons employed and records the results in a register known as the Health Register (Form No. 17), kept by the manager; power of suspension by an entry in the register.

Factory Medical Officer examinations of hazardous-process workers are recorded separately in Form 28 โ€” Rule 61-O (Medical Examination, in the 61-series hazardous-process rules): workers in a hazardous process are examined by the Factory Medical Officer once before employment and once every six months; details recorded in the Health Register in Form No. 28; no first employment without a Certificate of Fitness in Form 33 granted by the FMO; abnormalities reported to the Certifying Surgeon..

Assam uses Form 17 for Certifying Surgeon examinations and Form 28 for Factory Medical Officer examinations in hazardous processes.

Form 17 at a glance

  • โœ“ Health Register under the Assam Factories Rules, 1950
  • โœ“ For workers in notified dangerous operations (Section 87)
  • โœ“ Completed and signed by the Certifying Surgeon
  • โœ“ Certificate of Fitness: Form 33 (FMO, hazardous process); Form 27 / Form 28 certificates under the dangerous-operation schedules
  • โœ“ Kept by the factory manager; produced at each visit
  • โœ“ Hazardous-process register: Form 28
Plan a Periodic Medical Examination Batch
Question by question

Form 17 explained

Under which state rules is it prescribed?

The Assam Factories Rules, 1950, made under Section 112 of the Factories Act, 1948 and enforced by the Office of the Chief Inspector of Factories, Government of Assam.

Which rule prescribes it?

Rule 14 (Duties of Certifying Surgeon): at visits to factories carrying on dangerous operations the Certifying Surgeon examines the persons employed and records the results in a register known as the Health Register (Form No. 17), kept by the manager; power of suspension by an entry in the register.

Who maintains it?

The factory manager keeps Form 17 on the premises, produces it to the Certifying Surgeon at each visit and to the Inspector on demand. Form 17 / Form 28 registers and certificates kept by the manager and available to the Inspector.

Who completes and signs it?

The Certifying Surgeon appointed or authorised by the State Government under Section 10 of the Factories Act, 1948. An AFIH-qualified Factory Medical Officer does not sign the dangerous-operation entries unless that doctor also holds the Certifying Surgeon appointment.

When is it required?

Whenever the factory employs workers in any operation notified as dangerous under Section 87 and the schedules to the Assam Factories Rules, 1950 โ€” from the first examination after employment and at every periodic examination thereafter.

Which workers and processes does it cover?

Schedules (lead, chrome, silica, chemical works, solvents) require Certifying Surgeon examination at first employment and periodically with Form 17 entries and Form 27/28 certificates.

What information is recorded?

Worker identity and job, the process, the date and result of each examination by the Certifying Surgeon including the nature and results of tests, fitness or unfitness, any suspension with its period and reasons, and re-certification with the Certifying Surgeon's signature and date.

How frequently are examinations required?

Hazardous process: pre-employment, then every 6 months (Rule 61-O). Dangerous operations: as per schedule.

What is the role of the Factory Medical Officer?

Factory Medical Officer examinations of hazardous-process workers are recorded separately in Form 28 โ€” Rule 61-O (Medical Examination, in the 61-series hazardous-process rules): workers in a hazardous process are examined by the Factory Medical Officer once before employment and once every six months; details recorded in the Health Register in Form No. 28; no first employment without a Certificate of Fitness in Form 33 granted by the FMO; abnormalities reported to the Certifying Surgeon.. The FMO โ€” typically an AFIH-qualified doctor โ€” also runs the Occupational Health Centre (Rule 61-P (Occupational Health Centre): scaled by workforce โ€” retainer, part-time or full-time FMO with OHC facilities.) and reports abnormalities to the Certifying Surgeon.

What is the role of the Certifying Surgeon?

The Certifying Surgeon performs the dangerous-operation examinations, signs the register and certificates, suspends and re-admits workers, and gives the final opinion on appeals against the Factory Medical Officer's findings.

Can the examination be conducted at the factory premises?

Yes. The rules require the manager to provide a clean, ventilated, furnished room for the Certifying Surgeon's exclusive use during examinations at the factory. Our batches are organised on site.

How does Nodal Healthcare support the medical batch and documentation?

We map your processes to the Assam Factories Rules, 1950 schedules, run the on-site batch with AFIH-qualified doctors and technicians (Per schedule โ€” refinery and fertiliser exposure surveillance at Digboi, Numaligarh, Bongaigaon and Namrup; dust and noise surveillance for tea, plywood and paper factories.), coordinate the Certifying Surgeon's visit, prepare the Form 17 entries and certificates for signature and deliver digital records, statistics and a recall calendar.

Our Process

How Nodal Healthcare supports the Form 17 workflow

1

Process mapping

We review your factory licence and process list against the Assam Factories Rules, 1950 to confirm which workers fall under Form 17 and which tests and intervals apply.

2

On-site examination

AFIH-qualified occupational-health doctors and technicians examine workers at your premises; where the schedule requires the Certifying Surgeon, we coordinate their visit as part of the same batch.

3

Register & certificates

Entries are prepared in the prescribed Form 17 format with the correct signatory, together with the Certificates of Fitness, ready for the authority's inspection.

4

Digital copy & recall

You receive a digital copy, de-identified batch statistics and a due-date tracker for the next periodic examination.

FAQs

Form 17 โ€” common questions

Is Form 17 the only Health Register in Assam?

No. Form 17 is the Certifying Surgeon's register for dangerous operations; Factory Medical Officer examinations of hazardous-process workers go in Form 28, with a Certificate of Fitness in Form 33. A factory with both a hazardous process and a scheduled dangerous operation maintains both.

Can an AFIH doctor complete Form 17?

Only if that doctor is also appointed or authorised as a Certifying Surgeon by the State Government. The AFIH qualification alone does not confer that authority. We provide AFIH-qualified doctors for the Factory Medical Officer role and coordinate Certifying Surgeons for Form 17.

How did you verify the Form 17 requirement?

Assam Factories Rules, 1950 โ€” full consolidated text (non-government host); official cross-check pending (last checked 2026-09-12). This is a full consolidated text from a non-government host; we cross-check against the official portal before marking it verified, and confirm current requirements with the authority before every batch.

Need Form 17 entries for your Assam factory?

Send us your process list and headcount and we will scope the examination batch and documentation.

Verification record

Status: Corroborated โ€” official cross-check pending ยท Last checked: 2026-09-12. Source: Assam Factories Rules, 1950 โ€” full consolidated text (non-government host); official cross-check pending.