FORM D
[Rule 4(5)]
CERTIFICATE OF DELIVERY/MISCARRIAGE

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.
3. Inserted by GSR 70(E), dated 31st. January, 1996, w.e.f.1st. February, 1996.