FORM XIX: Wage Slip
[Rule 78(1(a)(i)]
Name and address of contractor Name and Father's /Husband's Name of the workman
_____________________________ ______________________________________________________
Nature and location         of   work For    the    Week     /    Fortnight  /Month    ending
__________________                    ______________________________________________________
    1. No. of days worked            _________________________________
    2. No. of units worked in case
                                   _________________________________
       of piece -- rate
    3. 3. Rate of daily wages /
                                _________________________________
       piece -- rate
    4. Amounts of overtime wages _________________________________
    5. Gross wages payable           _________________________________
    6. Deductions, if any            _________________________________
    7. Net amount of wages paid      _________________________________
Initials of the contractor or his representative