[FORM XI]

ORISSA MINIMUM WAGES RULES

[FORM-XI]
Wage Slip
[Rule 26(2) ]

Name of the establishment

Place

1. Name of employee with father's or

husband's name

2. Designation

3. Wages-period

4. Rate of wages payable:

(a) Basic

(b) D.A.

5. Total attendance/units of work done

6. Overtime wages

7. Gross wages payable

8. Total deductions

9. Net wages

Pay Incharge Employee's signature

Thumb-impression

1. Substituted by notification no. 5755-D/26.4.69 – O.G.P. III

P. 612 – D/A – 4-1969