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Demographic Profile Age and sex wise composition group Male 0-6yrs 7-14yrs : : Female
15-20yrs : 20-30yrs : 30-60yrs : 60 above : Social Profile: Religion Language Caste composition: Education. Number of members. Only primary Under-matriculate Matriculation/Higher secondary ITI/Diploma/Any other Vocational Graduation Health care o Where do you go immediately when you fall ill? Male /female SC,ST, OBC, General Hindu, Muslim, Christian, Others Gujrati,Oriya, Bengali, Telugu, Hindi, Others
1 = Govt hospital 2 = dispensary,
5= Gram panchayat tap water supply o o o o Where do you take bath? 1= Personal bathroom/ 2= Well/ 3= ponds/river Do you face problem of alcoholism/drug addiction amongst some members of your community ? (1= Y / 0= N) How do you tackle them? Enter text and group them later Do you feel as a part of the city or isolated from the city? (1= Y / 0= N) . 2 = Homeopathi.3 = Private clinic. 5 = Others. 3 = Ayurvedic o Where do you go in major health problem ? o Delivery: 1= Institutional/ 2= others Sanitation o Household cleanliness (1= Y / 0= N) o Do you use sanitary toilets? (1= Y / 0= N) o What is the major source of drinking water ? 1 = Well. 4 = Municipal water supply. 3= Tubewell. 4 = Quacks. 2= Ponds/Rivers.specify o What type of medicine you usually take for minor health problem? 1 = Allopathic.
3= 7000-10000.Economic: Family Income o What are sources of income of your family? More than one choice possible hence enter each item in separate fields • • • • • o Agriculture:own land or labour Daily labour : construction.if others. how ? Enter text and group them later o Do you feel standard of living in general has improved over last 10 years? . how do they manage ? Enter text and group them later o Average income of a household : 1= Less than 5000.specify Small entrepreneur Driver/Auto owner Street vendors ) What type of work ? Enter text and group them later How many women work ?( • • • • 1= Maid servant 2= Nursing 3= Daily labour 4 = SHGs/cooperatives o o Do children ( below 14 years) work ? them later (1= Y / 0= N) Where ? Enter text and group Don’t the same children go to school ? (1= Y / 0= N) If yes. 2= 5000-7000. 4= More than 10000 o Have the people changed their occupational pattern over a period of time ? (1= Y / 0= N) If yes .
you go to whom ? Moneylender/cooperative/friends More than one choice possible hence enter each item in separate fields What is the rate of interest normally you pay for the credit? Any suggestion??? .1= For most/ 2= For some/ 3= For few/ 4= none. you hold you’re a/c? Private/Government/postoffice/cooperatives? More than one choice possible hence enter each item in separate fields Do you have ATM card? (Y/N) (1= Y / 0= N) When you want your credit. o Do people have adequate skill base? Yes/No (1= Y / 0= N) Public distribution system o o o o Does it exist? Yes/No (1= Y / 0= N) What are the essential commodities available? Rice/sugar/kerosene/edible oil/all of the above More than one choice possible hence enter each item in separate fields Do people get regularly? How many have ration card ? (Y/N) (1= Y / 0= N) Access to Financial services o o o o o Do you have a bank A/c? (Y/N) (1= Y / 0= N) In what type of bank.