The Basics

What is Form 17?

Form 17 is the Health Register prescribed under Rule 14 of the Tamil Nadu Factories Rules, 1950, "in respect of persons employed in occupations declared to be dangerous operations under Section 87" of the Factories Act, 1948. It is completed by the State-appointed Certifying Surgeon, whose name appears at the head of the register, and records for each worker the nature of the job, the date of employment on the present work, the dates of medical examination, the result of each examination expressed as fit, unfit or suspended, the period and detailed reasons for any suspension, whether a certificate of unfitness or suspension was issued to the worker, the date of re-certification to resume duty, and the Certifying Surgeon's signature and date. The factory manager keeps it and produces it at each visit.

The form itself states that it is prescribed under Rule 14 and covers Section 87 dangerous operations; we have reproduced that from the form text. Because the full official consolidated text of the Tamil Nadu rules is not yet available online, we confirm the hazardous-process register and Certificate of Fitness form numbers with DISH Tamil Nadu for each client rather than quoting them here.

Form 17 at a glance

  • โœ“ Health Register prescribed under Rule 14, Tamil Nadu Factories Rules, 1950
  • โœ“ For persons employed in dangerous operations (Section 87)
  • โœ“ Completed and signed by the Certifying Surgeon
  • โœ“ Records fit / unfit / suspended, suspension reasons and re-certification
  • โœ“ Kept by the factory manager; produced at each visit
  • โœ“ Hazardous-process register and fitness form: confirmed per client with DISH Tamil Nadu
Plan a Periodic Medical Examination Batch
Question by question

Form 17 explained

Under which state rules is Form 17 prescribed?

The Tamil Nadu Factories Rules, 1950, framed under the Factories Act, 1948 and enforced by the Directorate of Industrial Safety and Health (DISH), Government of Tamil Nadu.

Which rule prescribes it?

Rule 14 โ€” the Certifying Surgeon's duties rule โ€” as stated on the face of the form.

Who maintains it?

The factory manager keeps Form 17 on the premises and produces it to the Certifying Surgeon at each visit and to the Inspector on demand.

Who completes and signs it?

The Certifying Surgeon appointed or authorised by the Government of Tamil Nadu under Section 10 of the Factories Act; each result, suspension and re-certification entry carries the Certifying Surgeon's signature and date.

When is it required?

Whenever the factory employs persons in occupations declared to be dangerous operations under Section 87 and the Tamil Nadu schedules โ€” from first employment and at every periodic examination.

Which workers and processes does it cover?

Workers in the scheduled dangerous operations โ€” lead, chrome and electroplating, solvents and dyes, silica and dust processes, fireworks and match manufacture, and the other operations notified in Tamil Nadu.

What information is recorded?

Name and job of the worker, date of employment on the present work, date of leaving or transfer with reasons, dates of examination by the Certifying Surgeon, result (fit / unfit / suspended), period and reasons of suspension, whether a certificate of unfitness or suspension was issued, date re-certified fit to resume duty, and the Certifying Surgeon's signature.

How frequently are examinations required?

As the relevant Tamil Nadu schedule prescribes โ€” commonly at first employment and at least every 12 months, with shorter intervals for certain exposures. Rule 95 sets out medical examination requirements for hazardous and dangerous processes.

What is the role of the Factory Medical Officer?

The FMO โ€” typically an AFIH-qualified doctor โ€” conducts the pre-employment and periodic examinations of hazardous-process workers under the Section 41-C provisions, runs the Occupational Health Centre and reports abnormalities to the Certifying Surgeon. The FMO does not sign Form 17.

What is the role of the Certifying Surgeon?

The Certifying Surgeon examines the dangerous-operation workers, records results in Form 17, suspends and re-certifies workers, and gives the final opinion on fitness disputes.

Can the examination be conducted at the factory premises?

Yes. The rules provide for examination at the factory in a room furnished by the manager for the Certifying Surgeon's use; our batches are organised on site across Tamil Nadu.

How does Nodal Healthcare support the medical batch and documentation?

We map your processes to the Tamil Nadu schedules, run the on-site batch with AFIH-qualified doctors and technicians, coordinate the Certifying Surgeon's visit, prepare the Form 17 entries for signature, confirm the hazardous-process register and certificate forms with DISH Tamil Nadu, 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 Tamil Nadu 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 Tamil Nadu?

Form 17 is the Certifying Surgeon's register for dangerous operations under Rule 14. The Tamil Nadu rules also provide for Factory Medical Officer examinations of hazardous-process workers with their own register and Certificate of Fitness; we are confirming those form numbers against the official consolidated text and do not publish them until verified.

Can an AFIH doctor complete Form 17?

Only if that doctor is also appointed or authorised as a Certifying Surgeon by the Government of Tamil Nadu. An 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.

What happens when a worker is marked "suspended" in Form 17?

The worker may not be employed in the dangerous operation for the period stated until the Certifying Surgeon, after further examination, records in Form 17 that the worker is re-certified fit to resume duty. Employers should arrange alternative placement in the meantime.

Need Form 17 entries for your Tamil Nadu 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: Form 17 (prescribed under Rule 14) as reproduced from the Tamil Nadu Factories Rules, 1950; official consolidated text cross-check pending with DISH Tamil Nadu.