FORM NO. 11 [Prescribed under Rule 791] Model Notice of periods of work for adults and children Name of factory: Place : District : Periods of work : Groups Women Children Men Total number Total number Description Remarks Total number of of Women of children of Groups Men employed employed employed A D G B C EF HI Group Relays Nature 23 123 123 Letter of 23 123 123 123 123 123 work On A working days B Form C To D From E To F From G To H On Partial working days From To From To From To Date on which this notice first exhibited ........................ (Signed) Manager