ABC Manufacturer

Industrial Engineering Department

Factory Name
Trainee Operator Recruitment Slip
Date: Operator Name: Age: Father/Husband's Name: Sex (Male/Female): Present Address: Permanent Address: Marital Status: Right/Left Handed: Any Relatives Working in our Organisation: Education: Languages

Balaji Jagannat h

Digitally signed by Balaji Jagannath DN: CN = Balaji Jagannath, C = IN Reason: I am the author of this document Location: Bangalore, India Date: 2007.08.30 14:30:02 +05'30'

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Medical History (Fitness Certificate Required): Test PBDA(Time) PBDB(Time) VAT (Score) 0 1 2 3 4 5 Score

BTT(Time) PBT(Time) CPT (Score)

Standard Target 25 Secs - 25 1 Min 15 Secs

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Left Hand

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Signature Of Training Supervisor

Signature Of Personnel Officer

Signature Of Senior IE