FORM D :Certificate of Delivery/Miscarriage

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[Rule 4(5)]

This is to certify that I examined _________ wife/daughter of ____________ a woman employed in _________ (name of ³[mine of circus]) and found that she has been delivered of a child/ has undergone miscarriage on ________ (date).

Date __________ Signature of registered midwife.

Definitions of "child" and "miscarriage" as in the Maternity Benefit Act, 1961-

1. "Child" includes a still-born child

2. "Miscarriage" means expulsion of the contents of a pregnant uterus at any period prior to or during the twenty-sixth week of pregnancy but does not include any miscarriage, the causing of which is punishable under the Indian Penal Code.

 

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