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ntreprinderea/Unitatea______________________________________

FISA DE INSTRUIRE COLECTIV


privind securitatea i sntatea n munc
ntocmita azi __________________

Subsemnatul ________________________, avnd funcia de ______________________,


am procedat la

instruirea unui numr de____ persoane de la _________________________,

conform tabelului nominal de pe verso, n domeniul securitii i sntii n munc, pentru vizita
(prezena) n ntreprindere/unitate n zilele ____________________________________________.
n cadrul instruirii s-au prelucrat urmtoarele materiale;
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Prezenta fi de instructaj se va pstra la ___________________________________________

Verificat,

Semntura celui care a


efectuat instruirea

TEBEL NOMINAL
cu persoanele participante la instruire
Subsemnaii am fost instruii i am luat cunotin de materialele prelucrate i consemnate
n fia de instruire colectiv privind securitatea i sntatea n munc i ne obligm s le respectm
ntocmai.

Nr. crt.

Numele i prenumele

Act identitate/grupa sanguin

Semntura

Numele i prenumele persoanei


care a primit un exemplar

Semntura

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