Company Name…… Format No: XXX/HR04/F-01-00
   VISITOR DECLARATION FORM
Rev No: 00
Effe. Date:
Name ................................................Dated .................. ............
You are suffering from or are doing the following: dress code of xxxxxxx……..,
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Disease Yes No |
Yes |
No |
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1 Flu / Influenza / Flu / Influenza |
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2 Typhoid / Typhoid |
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3 Tuberculosis / Tuberculosis |
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4 Viral Fever |
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5 Hepatitis / Hepatitis |
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6 Deep Cuts / Wounds / Deep Cuts / Wounds |
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7 Skin Infection |
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1. It is mandatory for all visitors to wear protective clothing provided by the company to enter the administration area.
2. Cap provided by the company should be worn by all personnel (cap should cover all hair). Safety beard netting should also be worn in case of beards.
3. Wearing the appropriate shoe is essential for cleanliness and safety. personal hygiene
1. All personnel entering the administration area should wash their hands with soap and sanitize with IPA.
2. Persons working in or entering the production area, shall have snipped clean nails, which are free from nail paint. Little finger nails are not allowed.
3. Persons working in or entering the manufacturing sector should not wear any ornaments other than a plain (without stone) ring and bracelet karri.
4. Watches, binds and religious wrist/neck threads should not be worn.
5. Smoking is prohibited in the factory premises.
6. Chewing of food or drinking of any edible articles/tobacco/liquor in production area is not permitted.
7. All cuts and scratches should be covered with a waterproof adhesive dressing.
I hereby declare that the information given above is true to the best of my knowledge and that I shall abide by the company's code of practice.
Visitor Signature                                      Authentication. signature
