The Basics

What is Form 17?

Form 17 is the Health Register prescribed by the West Bengal Factories Rules, 1958, framed under the Factories Act, 1948 and enforced by the Directorate of Factories, Labour Department, Government of West Bengal. Rule 16 (Duties of Certifying Surgeon) — sub-rule (5): 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, kept in Form No. 17 by the factory manager and produced at each visit; power of suspension by an entry in the register.

Form 17 is also the register in which the Factory Medical Officer records the pre-employment and periodic examinations of workers in a hazardous process — Rule 63-J (Medical Examination, under Sections 41-B, 41-C and 112): workers in a hazardous process are examined by the Factory Medical Officer once before employment and once every six months (or sooner if the Medical Inspector of Factories considers necessary); details recorded in the Health Register in Form 17; no first employment without a Certificate of Fitness in Form 25 granted by the FMO..

West Bengal uses a single Health Register — Form 17 — for both Certifying Surgeon (Rule 16) and Factory Medical Officer (Rule 63-J) examinations; note the OHC thresholds (51–250 / above 250) differ from most states.

Form 17 at a glance

  • ✓ Health Register under the West Bengal Factories Rules, 1958
  • ✓ For workers in notified dangerous operations (Section 87)
  • ✓ Completed and signed by the Certifying Surgeon
  • ✓ Certificate of Fitness: Form 25 (FMO, hazardous process); schedule-specific certificates for dangerous operations
  • ✓ Kept by the factory manager; produced at each visit
  • ✓ Hazardous-process register: Form 17
Plan a Periodic Medical Examination Batch
Question by question

Form 17 explained

Under which state rules is it prescribed?

The West Bengal Factories Rules, 1958, made under Section 112 of the Factories Act, 1948 and enforced by the Directorate of Factories, Labour Department, Government of West Bengal.

Which rule prescribes it?

Rule 16 (Duties of Certifying Surgeon) — sub-rule (5): 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, kept in Form No. 17 by the factory manager and produced at each visit; 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 and the Form 25 certificates are 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 West Bengal Factories Rules, 1958 — from the first examination after employment and at every periodic examination thereafter.

Which workers and processes does it cover?

Schedules (lead, chrome, electrolytic and other processes) require Certifying Surgeon examination at intervals specified by the Chief Inspector, normally at the factory, with a Health Register "as nearly as possible in Form No. 17" and suspension by written certificate in the register.

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 63-J). Dangerous operations: at intervals specified by the Chief Inspector per schedule, commonly every 12 months.

What is the role of the Factory Medical Officer?

Form 17 is also the register in which the Factory Medical Officer records the pre-employment and periodic examinations of workers in a hazardous process — Rule 63-J (Medical Examination, under Sections 41-B, 41-C and 112): workers in a hazardous process are examined by the Factory Medical Officer once before employment and once every six months (or sooner if the Medical Inspector of Factories considers necessary); details recorded in the Health Register in Form 17; no first employment without a Certificate of Fitness in Form 25 granted by the FMO.. The FMO — typically an AFIH-qualified doctor — also runs the Occupational Health Centre (Rule 63-K (Occupational Health Centres): scaled by workforce — OHC room of 15 sq. m for 51–250 workers; two-room OHC and full-time Factory Medical Officer above 250 workers (one more per additional 500).) 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 West Bengal Factories Rules, 1958 schedules, run the on-site batch with AFIH-qualified doctors and technicians (Per schedule — foundry and jute dust (spirometry, chest X-ray), heat-stress for Durgapur and Haldia units, blood lead and chrome inspections where applicable.), 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 West Bengal Factories Rules, 1958 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 — common questions

Is Form 17 the only Health Register in West Bengal?

Yes — West Bengal uses Form 17 for both the Certifying Surgeon's dangerous-operation examinations and the Factory Medical Officer's hazardous-process examinations, with different certificates of fitness (Form 25 (FMO, hazardous process); schedule-specific certificates for dangerous operations; hazardous process: Form 25).

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?

West Bengal Factories Rules, 1958 — full consolidated text (Indian Kanoon, non-government host); official factories.wb.gov.in PDF 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 West Bengal 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: West Bengal Factories Rules, 1958 — full consolidated text (Indian Kanoon, non-government host); official factories.wb.gov.in PDF cross-check pending.