FORM R
See rule 29J(2) (b)

Second and final notice of medical re-examination by Appellate Medical Board
No. Date
MEMORANDUM
Shri/Shrimati*.................................,Nature of employment.........................Serial number from Form B Register......................................son/daughter/wife* of..............................,failed to present himself/herself* for medical re-examination on ......................... in respect of which he/she* had been given a notice on .......................
He/She* is hereby again notified that he/she* should present himself/herself* for a medical re-examination by the Appellate Medical Board at....................................(give exact description of place) on**.............................. (give date) at .................................. (give time).
Shri/Shrimati*..............may note that if he/she* fails to submit himself/herself* for the medical re-examination aforesaid, he/she* shall not be retained in employment in the mine.
Signature of Manager
..........................mine.