It is hereby made the duty of any licensed physician who shall make a physical examination of any employee under the provisions of section 292.330, to make within twenty-four hours a triplicate report thereof to the department of health and senior services of the state of Missouri upon blanks to be furnished by said department upon request, and if any such disease or illness is found, the physician shall so report, and if any such disease is found, the report shall state the name and address and business of such employer and the nature of the disease in precise and definite terms of all the diseases or illness with which the employee is afflicted and the probable extent and duration thereof, the name and business of employer, and the last place and length of employment; provided, that the failure of any such physician to receive blanks from the department of health and senior services for making such a report shall not excuse the physician from making the report as herein required. Any physician who shall fail to make a report as required by this section shall be deemed guilty of a misdemeanor and upon conviction shall be fined not less than fifty dollars, and in each case shall stand committed until such fine and costs are paid unless otherwise discharged by due process of law.