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Social Service Field Work

XISS, Ranchi

Format for Case study


1. Name of Children/ Person: 2. Educational Qualification: 3. Mothers Name: 4. Fathers Name: 5. Religion & Caste: 6. Address: Present Address Male / Female: Date of Birth: Present Status: Present Status: Married / Unmarried Permanent Address

7. Nos. brothers and sisters in his / her family: 8. Details of Disability if any:

9. History of Disability:

10. Technical knowledge if any:

11. Personal skills on games & sports:

12. Working abilities:

13. Aim in Life:

14. Temperament and Leadership skills:

15. Sharing Attitude and team building capacity:

16. Capability for self sufficiency in Future:

17. Support Requirements: Physical Support Mental Support Technical support Financial Support Moral Support

18. Personal opinion if any (from candidate) 19. Investigators Opinion: 20. Any other information: Signature Date

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