@if (isset($isPdfMode) && $isPdfMode) {{ strtoupper($form ?? 'Form A') }} @endif @foreach ($rows ?? [] as $i => $r)
(See sub-rule (1) of Rule 3 of the Tamil Nadu Maternity Benefit Rules, 1967)

FORM A

Register of Muster Roll
NAME OF THE ESTABLISHMENT:
{{ $report['establishment_name'] ?? '' }}
ADDRESS OF THE ESTABLISHMENT:
{{ $report['address'] ?? '' }}
1. Name of the Woman and DOB / Age : {{ $r['name'] ?? '' }} ({{ $r['dob'] ?? '' }})
2. Name of the Husband or Father : {{ $r['father_or_husband'] ?? '' }}
3. Nature of Work : {{ $r['designation'] ?? '' }}
4. Date of which employed / DOJ : {{ $r['doj'] ?? '' }}
5. Dates with month and year in which she is employed, laid off or not employed : ....................................
6. Date of giving notice of pregnancy : ....................................
7. Date of giving notice delivery : ....................................
8. Date of production of proof of birth : ....................................
9. Date of production of proof of death, if any : ....................................
10. Date on which payment was made
Particulars Amount Date
(a) Maternity benefit paid in advance, if expected
(b) Subsequent payment of Maternity Benefit
(c) Bonus
(d) Leave wages as per section 9
(e) Leave wages as per section 10
@if (!$loop->last)
@endif @endforeach @if (isset($isPdfMode) && $isPdfMode) @endif