FORM XVII
[SEE RULE 52 (2) (A)]
MUSTER ROLL

Name and address of Contractor.
Nature and location of work.
Name and address of establishment in/under which inter-State migrant workmen are employed.
Name and address of Principal Employer.
For the month of.................................

Serial number	Name of Migrant workman	Father’s/Husbands name	Sex	Dates	Remarks