Contractor / Employee Site Screening Form

S.no Gate Pass No Induction Card No

1 Name

2 Father's Name
Fix your pass port
3 D.O.B & Age size photo here
Address:

Emergency Contact
5 1) 2)
Number
Permanent ID Detail
6
& Number

7 Identification mark

8 Blood Group Height & Weight

9 Blood pressure : Eye sight

10 Designation

11 Skill category :

Previous experience

1)
12
2)

3)

Date of Safety
13
Induction - Client

14 Date of Joining at Site

15 Reporting Supervisor

Induction Done and

16
Card Issued

17 Screening done by

Name & Sign

Worker/ Employee Contractor Incharge ABB Site Engg ABB HSE Officer
PAPI-HSE-SF-33