| Part I
: Location Particulars: |
|
| Part II
: Individual Particulars: |
|
| General and Socio-Cultural
Characteristics |
|
| Q. 1: |
Name of the
person |
|
| Q. 2: |
Relationship to head |
|
| Q. 3: |
Sex (Male/ Female) |
|
| Q. 4: |
Age last birthday (in
completed years) |
|
| Q. 5: |
Current marital status |
|
| Q. 6: |
Age at marriage (in completed
years) |
|
| Q. 7: |
Religion (write name of
the religion in full) |
|
| Q. 8: |
If Scheduled Caste, write
name of the Scheduled Caste from the list supplied |
|
| Q. 9: |
If Scheduled Tribe, write
name of the Scheduled Tribe from the list supplied |
|
| Q. 10: |
Mother tongue |
|
| Q. 11: |
Other languages known (enter
upto two languages in order of proficiency) |
|
| Q. 12: |
Literacy status (Literate/
Illiterate) |
|
| Q. 13: |
Highest educational level
attained
(for diploma or degree holder, also write the subject of specialisation) |
|
| Q. 14: |
If attending educational
institution |
|
| Q. 15: |
If the person is physically/mentally
disabled, give appropriate code number |
|
| Characteristics of
Workers and Non-workers |
|
| Q. 16: |
Did the person work any time
last year?
(includes even part time help or unpaid work on farm, family enterprise
or in any other economic activity)
(Categories: Main worker: If worked for 6 months or more, Marginal
Worker: If worked for less than 6 months, Non-Worker: If not worked
at all )
|
|
| Q. 17: |
Economic activity of Main
or Marginal Worker: |
|
| Q. 17(i): |
Category of the economic
activity of the Main or Marginal Worker |
|
| |
For Workers in Household
Industry and for other Workers only: |
|
| Q. 17(ii): |
Occupation of the person
(describe the actual work of the
person) |
|
| Q. 17 (iii) |
Describe in detail the nature of industry, trade or
service where the person works/ worked or of self
employment |
|
| Q. 17 (iv) |
Class of Worker |
|
| Q. 18: |
If Marginal Worker or Non-Worker,
under Q. 16, record non-economic activity |
|
| Q. 19: |
If Marginal Worker or Non-Worker,
is the person seeking/ available for work ? |
|
| Q. 20: |
Travel to place of work (for
Other Workers only): |
|
| Q. 20 (i): |
Distance from residence to
place of work in Kilometres |
|
| Q. 20 (ii): |
Mode of travel to place of
work |
|
| Migration Characteristics |
|
| Q. 21: |
Birth Place: Is the person
born in this village/ town ?
(If 'Yes', put dash (-) against Q. 21(i) and Q. 21 (ii) or,
If 'No', enter particulars:) |
|
|
Q. 21 (i)
|
State/Country
(If birth place within India, write the present name of the state
or if birth place outside India, write the present name of the country)
|
|
| Q. 21 (ii) |
District
[If birth place within India, write the present name of the district
or if birth place outside India, put dash (-)]
|
|
| Q. 22: |
Place of Last Residence:
Has the person come to this village/town from elsewhere ?
(If 'No', put dash (-) against Qs. 22(i) to 22 (v) or if 'Yes', give
following particulars:)
|
|
|
Q. 22 (i)
|
State/Country:
(If place of last residence within India, write the present name
of the state or if place of last residence outside India, write the present
name of the country)
|
|
| Q. 22 (ii) |
District:
[If place of last residence within India, write the present name
of the district or if place of last residence outside India, put dash
(-)]
|
|
| Q. 22 (iii) |
At the time of migration,
was the place of last residence: Rural/ Urban
|
|
| Q. 22 (iv) |
Reason for migration
of this person
|
|
| Q. 22 (v) |
Duration of stay
in this village or town since migration (in completed years)
|
|
| Fertility Particulars |
|
| Q. 23 |
Fertility
For Ever Married Women only(Currently Married, Widowed,
Divorced or Separated) : |
|
| Q. 23 (i) |
Number of children
surviving at present
(also include daughters and sons presently not staying in this household)
[Separately for Daughter(s) and Son(s)]
|
|
| Q. 23 (ii) |
Total number of
children ever born alive (include both living and dead daughters
and sons)
[Separately for Daughter(s) and Son(s)]
|
|
| |
For currently married women
only: |
|
| Q. 23 (iii) |
Number of children
born alive during last one year(after 9th February 2000)
[Separately for Daughter(s)
and Son(s)]
|
|
| PART III:For
Household engaged in cultivation/planation |
|
| (i) |
Total net area of land under
cultivation/ plantation (in Hectares) |
|
| (ii) |
Net area of irrigated land
(in Hectares) |
|
| (iii) |
Tenure status of land under
cultivation/ plantation
|
|