The Basics

What is Form 21?

Form 21 is the Health Register prescribed by the Chhattisgarh Factories Rules, 1962 (adapted from the Madhya Pradesh Factories Rules, 1962), framed under the Factories Act, 1948 and enforced by the Directorate of Industrial Health and Safety, Government of Chhattisgarh. Rule 19 (Duties of Certifying Surgeon) — sub-rule (8) onward: at visits to factories carrying on dangerous operations the Certifying Surgeon examines the persons employed and records the results in the Health Register in Form 21, kept by the manager; power of suspension by an entry in the register.

Form 21 is also the register in which the Factory Medical Officer records the pre-employment and periodic examinations of workers in a hazardous process — Rule 131 (Medical Examination): 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 21; no first employment without a Certificate of Fitness in Form 32 granted by the FMO; abnormalities reported to the Certifying Surgeon..

Chhattisgarh uses Form 21 for both Certifying Surgeon (Rule 19) and Factory Medical Officer (Rule 131) examinations, matching the Madhya Pradesh parent rules.

Form 21 at a glance

  • ✓ Health Register under the Chhattisgarh Factories Rules, 1962 (adapted from the Madhya Pradesh Factories Rules, 1962)
  • ✓ For workers in notified dangerous operations (Section 87)
  • ✓ Completed and signed by the Certifying Surgeon
  • ✓ Certificate of Fitness: Form 32 (Certificate of Fitness)
  • ✓ Kept by the factory manager; produced at each visit
  • ✓ Hazardous-process register: Form 21
Plan a Periodic Medical Examination Batch
Question by question

Form 21 explained

Under which state rules is it prescribed?

The Chhattisgarh Factories Rules, 1962 (adapted from the Madhya Pradesh Factories Rules, 1962), made under Section 112 of the Factories Act, 1948 and enforced by the Directorate of Industrial Health and Safety, Government of Chhattisgarh.

Which rule prescribes it?

Rule 19 (Duties of Certifying Surgeon) — sub-rule (8) onward: at visits to factories carrying on dangerous operations the Certifying Surgeon examines the persons employed and records the results in the Health Register in Form 21, kept by the manager; power of suspension by an entry in the register.

Who maintains it?

The factory manager keeps Form 21 on the premises, produces it to the Certifying Surgeon at each visit and to the Inspector on demand. Form 21 register and Form 32 certificates kept by the manager, produced to the Certifying Surgeon at each visit 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 Chhattisgarh Factories Rules, 1962 (adapted from the Madhya Pradesh Factories Rules, 1962) — from the first examination after employment and at every periodic examination thereafter.

Which workers and processes does it cover?

Schedules (lead, electrolytic processes, silica, chemical works) require Certifying Surgeon examination within 15 days of first employment and re-examination at 3- to 12-month intervals as prescribed, with Form 21 entries and Form 32 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 131). Dangerous operations: as per schedule.

What is the role of the Factory Medical Officer?

Form 21 is also the register in which the Factory Medical Officer records the pre-employment and periodic examinations of workers in a hazardous process — Rule 131 (Medical Examination): 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 21; no first employment without a Certificate of Fitness in Form 32 granted by the FMO; abnormalities reported to the Certifying Surgeon.. The FMO — typically an AFIH-qualified doctor — also runs the Occupational Health Centre (Rule 131-A (Occupational Health Centre): scaled by workforce — retainer, part-time or full-time FMO with OHC facilities; Rules 131-A to 131-D apply to hazardous-process factories.) 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 Chhattisgarh Factories Rules, 1962 (adapted from the Madhya Pradesh Factories Rules, 1962) schedules, run the on-site batch with AFIH-qualified doctors and technicians (Per schedule — heat-stress, spirometry and chest X-ray for sponge-iron, ferro-alloy and steel units at Raipur–Urla–Siltara, Bhilai and Raigarh; blood lead and metal-fume surveillance where applicable.), coordinate the Certifying Surgeon's visit, prepare the Form 21 entries and certificates for signature and deliver digital records, statistics and a recall calendar.

Our Process

How Nodal Healthcare supports the Form 21 workflow

1

Process mapping

We review your factory licence and process list against the Chhattisgarh Factories Rules, 1962 (adapted from the Madhya Pradesh Factories Rules, 1962) to confirm which workers fall under Form 21 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 21 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 21 — common questions

Is Form 21 the only Health Register in Chhattisgarh?

Yes — Chhattisgarh uses Form 21 for both the Certifying Surgeon's dangerous-operation examinations and the Factory Medical Officer's hazardous-process examinations, with different certificates of fitness (Form 32 (Certificate of Fitness); hazardous process: Form 32).

Can an AFIH doctor complete Form 21?

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 21.

How did you verify the Form 21 requirement?

Chhattisgarh Factories Rules, 1962 — 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 21 entries for your Chhattisgarh factory?

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

Verification record

Status: Corroborated — official cross-check pending · Last checked: 2026-09-12. Source: Chhattisgarh Factories Rules, 1962 — full consolidated text (non-government host); official cross-check pending.