Ishlab chiqarishdagi baxtsiz hodisalar va xodimlar salomatligining boshqa XIL zararlanishlarini tekshirish hamda


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Ishlab chiqarishdagi baxtsiz hodisalar va xodimlar salomatligining boshqa xil zararlanishlarini tekshirish hamda hujjatlashtirish

DALOLATNOMA №




Ishlab chiqarishdagi baxtsiz hodisa va salomatlikka boshqa xil zarar yetkazilishi to‘g‘risida

1. Korxonaning nomi_________________________________________________

1.1. Korxonaning manzili _____________________________________________




(viloyat, shahar, tuman, ko‘cha, uy)

1.2. Mulkchilik shakli _________________________________________________




(davlat, aksiyadorlik, xususiy va hokazo)

1.3. Baxtsiz hodisa yuz bergan joy________________________________________




(bo‘linma, sex)

2. Vazirlik, xo‘jalik boshqaruvi organi ___________________________________

3. Xodimni yo‘llagan korxona__________________________________________

(nomi, manzili, vazirlik xo‘jalik boshqaruvi organi)

4. Jabrlanuvchining familiyasi, ismi va otasining ismi

_________________________________________________________________

5. Jinsi: erkak, ayol (tagiga chizilsin)

6. Yoshi (to‘liq yillar soni ko‘rsatilsin) ___________________________________

7. Kasbi, lavozimi ___________________________________________________

7.1. Razryadi, klassi _________________________________________________

8. Baxtsiz hodisa yuz berganda bajarilayotgan ish bo‘yicha ish staji
___________________________________________________________________

9. Mehnat xavfsizligi bo‘yicha yo‘riqnoma, o‘qitish:

9.1. Kirish yo‘riqnomasi (sana) __________________________________________

9.2. Mehnat xavfsizligi bo‘yicha o‘qitish (sana)____________________________

9.3. Dastlabki (davriy) yo‘riqnoma (sana) _________________________________

9.4. O‘ta xavfli ishlar uchun bilimlarni tekshirish (sana) ___________________________________________________________________

9.5. Ishga kirayotganida va davriy tibbiy ko‘rikdan o‘tganligi
___________________________________________________________________

10. Baxtsiz hodisa yuz bergan sana va vaqt_______________________________




(yil, kun, oy)

__________________________________________________________________

(ish boshlashdan to‘liq soatlar soni)

11. Baxtsiz hodisa holati _______________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

11.1. Baxtsiz hodisa sabablari
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

11.2. Jarohat yetkazilishga sabab bo‘lgan asbob-uskuna
______________________________________________________________________________________________________________________________________

11.3. Jabrlanuvchining hushyorligi (alkogol yoki narkotiklar ta’siridaligi)
__________________________________________________________________

(tibbiy xulosaga binoan)

11.4. Tashxis _______________________________________________________________

(dastlabki, oxirgi)

12. Baxtsiz hodisa sabablarini bartaraf etish tadbirlari:

_________________________________________________________________
___________________________________________________________________
___________________________________________________________________

13. Mehnat to‘g‘risidagi qonunchilik, mehnatni muhofaza qilish qoidalari va me’yorlari buzilishiga yo‘l qo‘ygan shaxslar __________________________________________________

(F.I.Sh., lavozimi, korxona nomi)

___________________________________________________________________

(ular tomonidan buzilgan qonunlar, qoidalar va me’yoriy hujjatlarning moddalari, bandlari)




14. Baxtsiz hodisa guvohlari __________________________________________

Dalolatnoma tuzildi___________________________________________________

(yil, kun, oy)

Komissiya raisi

_________________________________________




(F.I.Sh., imzo)

Komissiya a’zolari

___________________________________




(F.I.Sh., imzo)





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