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Village Qustionnaire – Part B 60
Social and Political groups in village fpuhkj;jpy; cs;s murpay; kw;Wk; rK:f mikg;g[f;fs;
S.
no
TYPE OF GROUP
How many [……] exist in this
village? [No. of groups – zero
value possible].
,f;fpuhkj;jpy; [……] vj;jid FGf;fs; cs;sd> [ FGf;fspd; vz;zpf;if ? g{$;$pak; rhj;jpak; ]
What are the names of all groups and organizations in the village? fpuhkj;jpy; cs;s midj;J FGf;fs; kw;Wk; midj;J mikg;g[f;fspd;
bgau;fs; vd;bdd;d>
385. 386.
1.
Self help group(SHG) for
women only
bgz;fSf;fhd Ra cjtpf; FGf;fs; (list name of the
organization and Bank / MFI
Linked to Group affiliated)
(m’;fPfupf;fg;gl;l FGf;fSld; ,izf;fg;gl;Ls;s epWtd’;fs;-t’;fpfs; kw;Wk; FW epjp epWtd’;fspd; bgau;fisg; gl;oayplt[k;)
Group Name
FGtpd; bgau; Linked Bank or
MFI
,izf;fg;gl;l t’;fp my;yJ FW epjp epWtdk;
CODE
FwpaPL
2.
Other Self help group (SHG)
kw;w Ra cjtpf; FGf;fs;
Group Name
FGtpd; bgau; Linked Bank or
MFI
,izf;fg;gl;l t’;fp my;yJ FW epjp epWtdk;
CODE
FwpaPL
3.
Mothers’ Committee
/Magalir Sangam
jha;khu;fs; mikg;g[ - kfspu; r’;fk;
4.
Non government
organization
(NGO)
muR rhuh bjhz;L epWtdk; epWtdk; (list specific names)
(bgah;fis tupirahf Fwpf;ft[k;)
5.
Religious group
Md;kPf FGf;fs; (list groups)
(FGf;fis gl;oayplt[k;)
Name of group
FGtpd; bgau; Religion
kjk; Religion
Code
kjj;jpd; FwpaPL
Village Qustionnaire – Part B 61
S.
no
TYPE OF GROUP
How many [……] exist in this
village? [No. of groups – zero
value possible].
,f;fpuhkj;jpy; [……] vj;jid FGf;fs; cs;sd> [ FGf;fspd; vz;zpf;if ? g{$;$pak; rhj;jpak; ]
What are the names of all groups and organizations in the village? fpuhkj;jpy; cs;s midj;J FGf;fs; kw;Wk; midj;J mikg;g[f;fspd;
bgau;fs; vd;bdd;d>
385. 386.
6.
Political parties
murpay; fl;rpfs; (list parties)
(fl;rpfis gl;oayplt[k;;)
Name of Party
fl;rpapd; bgau; Party CODE
fl;rpapd; FwpaPL
7.
Caste Associations
$hjp r’;f’;fs; Name of Group
FGtpd; bgau; Caste
$hjp Caste
(Jati)
CODE
$hjp (FwpaPL)
8.
Village Development
Committee
fpuhk nkk;ghl;Lf; FG
9.
Village Tribal Development
Agency
fpuhk gH’;Fo nkk;ghl;L epWtdk;
10.
Village Education
Committee
fpuhk fy;tpf; FG
11.
Committees on Irrigation and water
use or Water Users Association or
Watershed Committee
ghrdk; kw;Wk; jz;zPu; gad;ghl;ow;fhd fkpl;ofs; my;yJ jz;zPu; gad;gLj;Jnthupd; r’;fk; my;yJ ePh; gfph;t[f;fhd thl;lu;b&l; fkpl;o
12.
Cooperatives
Tl;Lwt[r; r’;f’;fs; (list specific names)
(Fwpg;gpl;l bgah;fisg; gl;oayplt[k;)
13.
Business associations
tu;j;jf r’;f’;fs; (list specific names)
(Fwpg;gpl;l bgah;fisg; gl;oayplt[k;)
14.
Others (Specify)
kw;wit (Fwpg;gplt[k;)
15.
Others (Specify)
kw;wit (Fwpg;gplt[k;)
Village Qustionnaire – Part B 62
BANKS / MFIs – Code t’;fpfs; - FW epjp epWtd’;fspd; ? FwpaPL
Options Code Allahabad Bank my\hghj; t’;fp 01 Andhra Bank Me;jpuh t’;fp 02
Bank of Baroda ng’;f; M`g; gnuhlh 03
Bank of India ng’;f; M`g; ,e;jpah 04
Bank of Maharashtra ng’;f; M`g; k\huh&;;l;uh 05
Canara Bank fduh ng’;f; 06 Central Bank of India brd;l;uy; ng’;f; M`g; ,e;jpah 07 Corporation bank fhh;g;gnu&d; ng’;f; 08 Dena Bank njdh t’;fp 09
ICICI IrpIrpI 10 Indian Bank ,e;jpad; ng’;f; 11
Indian Overseas Bank ,e;jpad; Xtu;rP!; ng’;f; 12
Karur Vysya Bank fU:u; it!;ah t’;fp 13
Oriental Bank of Commerce Xupaz;ly; ng’;f; M`g; fhku;!; 14
Punjab and Sind Bank g”;rhg; mz;l; rpe;J ng’;f; 15
Punjab National Bank g”;rhg; ne&dy; ng’;f; 16
State Bank of India !;nll; ng’;f; M`g; ,e;jpah 17 Syndicate Bank rpz;onfl; ng’;f; 18 Tamilnad Mercantile bank jkpH;ehL bku;f;fz;ily; ng’;f; 19
UCO bank a{nfh ng’;f; 20 Union Bank of India a{dpad; ng’;f; M`g; ,e;jpah 21
United Bank of India a[idl;bll; ng’;f; M`g; ,e;jpah 22
Vijaya Bank it!;ah ng’;f; 23
Other Bank (Specify) kw;w t’;fpfs; (Fwpg;gplt[k;) 24
Activist for Social Alternatives (ASA) rK:f khw;w’;fSf;fhd eltof;iff; FG 25
Bullock cart Workers Development Association(BWDA) khl;L tz;o bjhHpyhsu;fs; nkk;ghl;L mikg;g[ 26
Community Action for Rural Development(CARD) fpuhk nkk;ghl;L rK:f eltof;if 27
Ecumenical Church Loan Fund of India(ECLOF) vf;a{bkdpf;fy; ru;r; nyhd; `gd;L M`g; ,e;jpah 28
Guidance Society for Labour Orphans &
Women(GLOW)
CHpau;fs;. mdhij kw;Wk; bgz;fSf;fhd tHpfhlLk; mikg;g[ (f;nsh)
29
Indian Association for Saving & Credit(IASC) nrkpg;g[ kw;Wk; flDf;fhd ,e;jpa mikg;g[ (IVv!;rp) 30
Integrated Village Development Project(IVDP) xU’;fpize;j fpuhk nkk;ghl;L jpl;lk; (Itpogp) 31
Kalanjiam Development Financial Services (KDFS) fs”;rpak; nkk;ghl;L epjp nrit 32 Kalrayan Hills ADP(KHADP) fy;tuhad; kiy gFjp nkk;ghl;Lj; jpl;lk; 33 League for Education & Development(LEAD) fy;tp kw;Wk; nkk;ghl;L xU’;fpize;j FG[ 34
MAHASEMAM k\hnrkk; 35 Micro Finance Consulting Group(MCG) FW epjp Mnyhrid FG 36
Nanayasurabhi Development Financial Services(NDFS) ehza Rugp nkk;ghl;L epjp nritfs; 37
NEW LIFE g[J thH;t[ 38 OAZOANE(The Society for Development of Human
Abilities and Environment)
Xnrhd; (kzpj jpwikfisa[k; Rw;Wf; R{Hiya[k; nkk;gLj;Jk; r’;fk;)
39
PIONEER TRAD gadPu; onul; 40
PREPARE g;uPngu; 41
Samam Makalir Suyasarbu Iyakkam rkk; kfspu; Ra rhh;g[ ,af;fk; 42 Sarvodaya Nano Finance Ltd. (SNF) ru;nthjah ehndh epjp epWtdk; 43 Semam Micro Finance Investment Literacy &
Empowerment Ltd. (SMILE)
nrkk; FW epjp fy;tp KjyPL kw;Wk; jpwd; btspg;ghL epWtdk;
44
Serva Jana Seva Kosh Ltd. (SJSK) nru;th $d nrth nfh&; ypl; 45
Seva Mahalir Sangamam nrth kfspu; r’;fk; 46 Thirumalai Charity Trust (TCT) jpUkiy rhupl;o ou!;l; 47 Other MFI (Specify) kw;w FW epjp epWtd’;fs; (Fwpg;gplt[k;) 48
Religion Code kjj;jpd; FwpaPL Options Code
Hinduism ,e;J kjk; 01
Islam ,!;yhk; 02
Christianity fpU!;Jtk; 03
Sikhism rPf;fpak; 04
Jainism i$dk; 05
Buddhism bgsj;jk; 06
Zoroastrianism (Parsi) ghh;rp 07
Others____________ kw;wit 08
Village Qustionnaire – Part B 63
Political party Code murpay; fl;rp FwpaPLmurpay; fl;rp FwpaPLmurpay; fl;rp FwpaPLmurpay; fl;rp FwpaPL Options Code
All India Anna Dravida Munnetra Kazhagam
(AIADMK)
midj;jpe;jpa mz;zh jpuhtpl Kd;ndw;wf; fHfk; 01
Bharatiya Janata Party (BJP) ghujpa $djh fl;rp 02
Communist Party of India (CPI) ,e;jpa fk;a{dp!;l; fl;rp 03
Communist Party of India (Marxist) (CPI-M) khu;f;!pa fk;a{dp!;l; fl;rp 04
Dravida Munnetra Kazhagam (DMK) jpuhtpl Kd;ndw;w fHfk; 05
Indian National Congress (INC) ,e;jpa njrpa fh’;fpu!; 06
Marumalarchi Dravida Munnetra Kazhagam
(MDMK)
kWkyu;r;rp jpuhtpl Kd;ndw;wf; fHfk; 07
Pattali Makkal Katchi (PMK) ghl;lhsp kf;fs; fl;rp 08
All India Forward Bloc (Subhasist) mfpy ,e;jpa `ghh;thu;l; gpshf; (Rgh&p!k;) 09
Democratic Forward Bloc. $dehaf `ghh;thh;l; gpshf; 10
Puthiya Tamilagam g[jpa jkpHfk; 11
Dalit Panthers of India (DPI) or Viduthalai
Siruthaigal
tpLjiy rpWj;ijfs; 12
Muslim League K!;yPk; yPf; 13
Dhesiya Murtpokku Dravida Kazhagam
(DMDK)
njrpa Kw;nghf;F jpuhtpl fHfk; 14
All India Samathuva Makkal Katchi midj;jpe;jpa rkj;Jt kf;fs; fl;rp 15
Others___________ kw;wit 16
Others___________ kw;wit 17
Village Qustionnaire – Part B 64
Election Summary: GP election and villages
njh;jy; gw;wpa tpgu’;fs; : fpuhk g”;rhaj;J njh;jy; kw;Wk; fpuhk’;fs; When were the elections
held?
njh;jy; vg;nghJ eilbgw;wJ>
No. of villages represented
by [ ]?
(/////) ?y; g’;bfLj;Jf;bfhz;l fpuhk’;fspd;
vz;zpf;if vd;d>
Number of members of
Panchayat?
g”;rhaj;J cWg;gpdu;fspd; vz;zpf;if vd;d>
Total number of eligible voters in this
panchayat ,e;j g”;rhaj;jpy; jFjp bgw;w thf;fhsu;fspd; vz;zpf;if vd;d>
Total Votes polled gjpthd thf;Ffspd; bkhj;j vz;zpf;if
Total number of GP
meetings held
bkhj;jk; vj;jid fpuhk g";rhaj;J Tl;l’;fs; eilbgw;wJ>
Total number of gram
sabha meetings held
bkhj;jk; vj;jid fpuhkrgh Tl;l’;fs; eilbgw;wJ> Year
tUlk;
YYYY
Month
khjk;
MM
387. 388. 389. 390. 391. 392. 393.
Elections
Oct. 2006
mf;/ 2006 njh;jy;fs;
Panchayat
2001 – 2006
g";rhaj;J 2001 ? 2006
Details of Villages Represented By This Panchayat ,e;j g”;rhaj;jpy; m’;fk; tfpf;Fk; fpuhk’;fspd; tptu’;fs;
SI Number
tupir vz; Name of the village
fpuhkj;jpd; bgau; Distance from this village (km.)
,e;j fpuhkj;jpy; ,Ue;J J}uk; (fp/kP) Q.No 394. 395.
1 (panchayat headquarters)
g”;rhaj;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;J jiyikafk;
2
3
4
5
6
7
Village Qustionnaire – Part B 65
CANDIDATE SUMMARY: VOTES POLLED BY EACH CANDIDATE FOR PANCHAYAT PRESIDENT -2006 Panchayat ntl;ghsupd; tpntl;ghsupd; tpntl;ghsupd; tpntl;ghsupd; tptu’;fs; ? tu’;fs; ? tu’;fs; ? tu’;fs; ? g”;rhaj;J jiytu; njh;jypy; g”;rhaj;J jiytu; njh;jypy; g”;rhaj;J jiytu; njh;jypy; g”;rhaj;J jiytu; njh;jypy; xt;bthUxt;bthUxt;bthUxt;bthU ntl;ghsUk; bgw;w Xl;Lf;fs; ntl;ghsUk; bgw;w Xl;Lf;fs; ntl;ghsUk; bgw;w Xl;Lf;fs; ntl;ghsUk; bgw;w Xl;Lf;fs; = = = = mf;nlhgu; 2006 g”;rhaj;J nju;jy;mf;nlhgu; 2006 g”;rhaj;J nju;jy;mf;nlhgu; 2006 g”;rhaj;J nju;jy;mf;nlhgu; 2006 g”;rhaj;J nju;jy;
CANDIDATE SUMMARY: Panchayat elections
ntl;ghsu;fspd; tptu’;fs; ? g”;rhaj;J nju;jy;;
October 2006 Panchayat President mf;nlhgu; 2006 g”;rhaj;J mf;nlhgu; 2006 g”;rhaj;J mf;nlhgu; 2006 g”;rhaj;J mf;nlhgu; 2006 g”;rhaj;J jiytu;jiytu;jiytu;jiytu;nju;jy;nju;jy;nju;jy;nju;jy;
Within village support based
on …
(///////) mog;gilapy; fpuhkj;jpy;;;;; cs;stu;fspd; Mjut[ ( Muliple response possible
Xd;Wf;F nkw;gl;l gjpy; tuyhk;
outside support based on
(…..)
(///////) mog;gilapy; fpuhkj;jpw;F btspapy; cs;sth;fspd; Mjut[ Muliple response possible
Xd;Wf;F nkw;gl;l gjpy; tuyhk;
Mode of election
1=direct election;
2=unopposed njh;jy; Kiw ? 01 ? neuoj; njh;jy; 02 ? vjpu; nghl;oapy;yhky; njh;t[
Total
number of
votes polled
gjpthd thf;Ffspd; bkhj;j vz;zpf;if
Total number
of votes
received by
this candidate
,e;j ntl;ghsh; bgw;w thf;Ffspd; bkhj;j vz;zpf;if
Does this
person live in
the village?
mtu; ,e;j fpuhkj;jpy; trpf;fpd;whuh>
If yes, HH
ID
Mk; vdpy;. FLk;g milahs vz;
MEMBER
ID
cWg;gpdu; milahs vz;
Candidate NAME
nghl;oapl;lth; bgah;
Gender
ghypdk; Caste (Jati
NAME]
$hjp (bgau;)
Jati
CODE
$hjp FwpaPL
Religion
kjk; CODE FwpaPL
Caste
(jati)
$hjp
Relig
ion
kjk;
wealthy
person
bry;te;ju;
Caste
(jati)
$hjp
Religion
kjk; Political
party murpay; fl;rp
Yes
Mk; No
,y;iy >NEXT
ROW M
Mz;
F
bgz;
396. 397. 398. 399. 400. 401. 402. 403. 404. 405. 406. 407. 408.
01 02
01 02 03 01 02 03
01 02
01 02
01 02 03 01 02 03
01 02
01 02
01 02 03 01 02 03
01 02
01 02
01 02 03 01 02 03
01 02
01 02
01 02 03 01 02 03
01 02
01 02
01 02 03 01 02 03
01 02
01 02
01 02 03 01 02 03
01 02
01 02
01 02 03 01 02 03
01 02
Village Qustionnaire – Part B 66
CANDIDATE SUMMARY: VOTES POLLED BY EACH CANDIDATE FOR PANCHAYAT PRESIDENT – 2001 Panchayat ntl;ghsupd; tptu’;fs; ? g”;rhaj;J jiytu; njh;jypy; xt;bthU ntl;ghsUk; bgw;w Xl;Lf;fs; = mf;nlhgu; 2001 g”;rhaj;J nju;jy;ntl;ghsupd; tptu’;fs; ? g”;rhaj;J jiytu; njh;jypy; xt;bthU ntl;ghsUk; bgw;w Xl;Lf;fs; = mf;nlhgu; 2001 g”;rhaj;J nju;jy;ntl;ghsupd; tptu’;fs; ? g”;rhaj;J jiytu; njh;jypy; xt;bthU ntl;ghsUk; bgw;w Xl;Lf;fs; = mf;nlhgu; 2001 g”;rhaj;J nju;jy;ntl;ghsupd; tptu’;fs; ? g”;rhaj;J jiytu; njh;jypy; xt;bthU ntl;ghsUk; bgw;w Xl;Lf;fs; = mf;nlhgu; 2001 g”;rhaj;J nju;jy;
CANDIDATE SUMMARY: Panchayat elections
ntl;ghsu;fspd;; tptu’;fs; ? g”;rhaj;J nju;jy;fs;;
2001 – 2006 Panchayat –
Previous Panchayat Election (2001 ? 2006 g”;rhaj;J) ? Ke;ija g”;rhaj;J nju;jy;
Within village support
based on …
(///////) mog;gilapy; fpuhkj;jpy;;;;; cs;stu;fspd; Mjut[ ( Muliple response possible
Xd;Wf;F nkw;gl;l gjpy; tuyhk;
outside support based on
(…..)
(///////) mog;gilapy; fpuhkj;jpw;F btspapy; cs;sth;fspd; Mjut[ Muliple response possible
Xd;Wf;F nkw;gl;l gjpy; tuyhk;
Mode of
election
1=direct
election;
2=unopposed
njh;jy; Kiw 01 ? neuoj; njh;jy; 02 ? nghl;oapy;yhky; njh;t[
Total
number of
votes
polled
gjpthd bkhj;j thf;Ffspd; vz;zpf;if
Total
number of
votes
received by
this
candidate
,e;j ntl;ghsh; bgw;w thf;Ffspd; bkhj;j vz;zpf;if
Does this
person live in
the village?
mtu; ,e;j fpuhkj;jpy; trpf;fpd;whuh>
If yes,
HH ID
Mk; vdpy;. FLk;g milahs vz;
MEMBER
ID
cWg;gpdu; milahs vz;
Candidate
NAME
nghl;oapl;lth; bgah;
Gender
ghypdk; Caste
(Jati
NAME]
$hjp (bgau;)
Jati
CODE
$hjp FwpaPL
Religion
kjk; CODE FwpaPL
Caste
(jati)
$hjp
Religion
kjk; wealthy
person
bry;te;ju;
Caste
(jati)
$hjp
Religion
kjk; Political
party
murpay; fl;rp
Yes
Mk; No
,y;iy >NEXT
ROW M
Mz; F
bgz;
409. 410. 411. 412. 413. 414. 415. 416. 417. 418. 419. 420. 421.
01 02
01 02 03 01 02 03
01 02
01 02
01 02 03 01 02 03
01 02
01 02
01 02 03 01 02 03
01 02
01 02
01 02 03 01 02 03
01 02
01 02
01 02 03 01 02 03
01 02
01 02
01 02 03 01 02 03
01 02
01 02
01 02 03 01 02 03
01 02
01 02
01 02 03 01 02 03
01 02
Village Qustionnaire – Part B 67
CANDIDATE SUMMARY: VOTES POLLED BY EACH ELECTED MEMBER, 2006 PANCHAYAT
ntl;ghsupd; tptu’;fs;/ntl;ghsupd; tptu’;fs;/ntl;ghsupd; tptu’;fs;/ntl;ghsupd; tptu’;fs;/; nju;t[ bra;ag;gl;l xt;bthU g”;rhaj;J cWg;gpdUk; ; nju;t[ bra;ag;gl;l xt;bthU g”;rhaj;J cWg;gpdUk; ; nju;t[ bra;ag;gl;l xt;bthU g”;rhaj;J cWg;gpdUk; ; nju;t[ bra;ag;gl;l xt;bthU g”;rhaj;J cWg;gpdUk; bgw;w bgw;w bgw;w bgw;w Xl;Lf;fs;Xl;Lf;fs;Xl;Lf;fs;Xl;Lf;fs; = 2006 = 2006 = 2006 = 2006 g”;rhaj;J nju;jy;g”;rhaj;J nju;jy;g”;rhaj;J nju;jy;g”;rhaj;J nju;jy;
Member's Name
cWg;gpdUila bgau; Number of
candidates contested
for this post
,e;j gjtpf;Fg; nghl;oapl;l ntl;ghsu; fspd; vz;zpf;if
[Mode of election
01=direct election;
02=unopposed
njh;jy; Kiw 01 ? neuoj; njh;jy; 02 ? vjph; nghl;oapy;yhky; njh;t[
Total number of votes
polled
gjpthd thf;Ffspd; bkhj;j vz;zpf;if
Total number of votes received
by this candidate
,e;j ntl;ghsh; bgw;w thf;Ffspd; bkhj;j vz;zpf;if
Q.no 422. 423. 424. 425. 426.
WARD _____ gFjp
Member 1
cWg;gpdh; 1
Member 2
cWg;gpdh; 2
Member 3
cWg;gpdh; 3
WARD _____
gFjp
Member 1
cWg;gpdh; 1
Member 2
cWg;gpdh; 2
Member 3
cWg;gpdh; 3
WARD _____
gFjp
Member 1
cWg;gpdh; 1
Member 2
cWg;gpdh; 2
Member 3
cWg;gpdh; 3
Village Qustionnaire – Part B 68
Member's Name
cWg;gpdUila bgau; Number of candidates contested
for this post
,e;j gjtpf;Fg; nghl;oapl;l tu;fspd; vz;zpf;if
[Mode of election
01=direct election;
02=unopposed
njh;jy; Kiw ? 01 ? neuoj; njh;jy; 02 ? vjph; nghl;oapy;yhky; njh;t[
Total number of votes
polled
gjpthd thf;Ffspd; bkhj;j vz;zpf;if
Total number of votes
received by this candidate
,e;j ntl;ghsh; bgw;w thf;Ffspd; bkhj;j vz;zpf;if
WARD _____
gFjp
Member 1
cWg;gpdh; 1
Member 2
cWg;gpdh; 2
Member 3
cWg;gpdh; 3
WARD _____ gFjp
Member 1
cWg;gpdh; 1
Member 2
cWg;gpdh; 2
Member 3
cWg;gpdh; 3
WARD _____
gFjp
Member 1
cWg;gpdh; 1
Member 2
cWg;gpdh; 2
Member 3
cWg;gpdh; 3
WARD _____ gFjp
Member 1
cWg;gpdh; 1
Member 2
cWg;gpdh; 2
Member 3
cWg;gpdh; 3
Village Qustionnaire – Part B 69
VOTES POLLED BY EACH ELECTED MEMBER OF 2001-2006 PANCHAYAT ( Previous Panchayat Election)
2001 2001 2001 2001 ???? 2006 2006 2006 2006 g”;rhaj;J nju;jypy;g”;rhaj;J nju;jypy;g”;rhaj;J nju;jypy;g”;rhaj;J nju;jypy; nju;t[ bra;ag;gl;l xt;bthU g”:;rhaj;J cWg;gpdUk; nju;t[ bra;ag;gl;l xt;bthU g”:;rhaj;J cWg;gpdUk; nju;t[ bra;ag;gl;l xt;bthU g”:;rhaj;J cWg;gpdUk; nju;t[ bra;ag;gl;l xt;bthU g”:;rhaj;J cWg;gpdUk; bgw;w bgw;w bgw;w bgw;w Xl;Lf;fs;Xl;Lf;fs;Xl;Lf;fs;Xl;Lf;fs; (((( Ke;ija g”;rhaj;J njuKe;ija g”;rhaj;J njuKe;ija g”;rhaj;J njuKe;ija g”;rhaj;J nju;jy;;jy;;jy;;jy;))))
Member's Name
cWg;gpdUila bgau;
Number of candidates contested for this post
,e;j gjtpf;Fg; nghl;oapl;l tu;fspd; vz;zpf;if
[Mode of election
01=direct election;
02=unopposed
njh;jy; Kiw 01 ? neuoj; njh;jy; 02 ? vjph; nghl;oapy;yhky; njh;t[
Total number of votes polled
gjpthd thf;Fffspd; bkhj;j vz;zpf;if
Total number of votes received by this candidate
,e;j ntl;ghsh; bghw;w thf;Ffspd; bkhj;j vz;zpf;if
Q.no 427. 428. 429. 430. 431.
WARD _____
gFjp
Member 1
cWg;gpdh; 1
Member 2
cWg;gpdh; 2
Member 3
cWg;gpdh; 3
WARD _____
gFjp
Member 1
cWg;gpdh; 1
Member 2
cWg;gpdh; 2
Member 3
cWg;gpdh; 3
WARD _____ gFjp
Member 1
cWg;gpdh; 1
Member 2
cWg;gpdh; 2
Member 3
cWg;gpdh; 3
Village Qustionnaire – Part B 70
Member's Name
cWg;gpdUila bgau;
Number of candidates contested
for this post
,e;j gjtpf;Fg; nghl;oapl;l tu;fspd; vz;zpf;if
[Mode of election
01=direct election;
02=unopposed
njh;jy; Kiw ? 01 ? neuoj; njh;jy; 02 ? vjph; nghl;oapy;yhky; njh;t[
Total number of votes
polled
gjpthd thf;Ffspd; bkhj;j vz;zpf;if
Total number of votes
received by this candidate
,e;j ntl;ghsh; bgw;w thf;Fffspd; bkhj;jvz;zpf;if
WARD _____
gFjp
Member 1
cWg;gpdh; 1
Member 2
cWg;gpdh; 2
Member 3
cWg;gpdh; 3
WARD _____
gFjp
Member 1
cWg;gpdh; 1
Member 2
cWg;gpdh; 2
Member 3
cWg;gpdh; 3
WARD _____
gFjp
Member 1
cWg;gpdh; 1
Member 2
cWg;gpdh; 2
Member 3
cWg;gpdh; 3
WARD _____ gFjp
Member 1
cWg;gpdh; 1
Member 2
cWg;gpdh; 2
Member 3
cWg;gpdh; 3
Village Qustionnaire – Part B 71
DETAILS ABOUT GRAM PANCHAYAT (ELECTED OCT 2006): Note that the filled-in boxes for Panchayat president indicate information already collected in the election summary fpuhk g”;rhaj;J gw;wpa tptu’;fs; (mf; ? 2006 ?y; nju;t[ bra;ag;gl;lJ) Fwpg;g[ ? g”;rhaj;J jiytUf;fhf g”;rhaj;J jiytUf;fhf g”;rhaj;J jiytUf;fhf g”;rhaj;J jiytUf;fhf g{u;j;jp bra;ag;gl;Ls;s bgl;ofSf;F njh;jy; bjhFg;gpy; ,Ue;J Vw;fdnt jfty;fs; nrfupf;fg;gl;Ls;sd
Sl.
No. tupir vz;
Position
bghWg;g[
Name
bgau;
Gender
ghypdk;
Res
erv
atio
n?
[CO
DE
giv
en b
elo
w)
xJf;fPL FwpaPL (fPnH
fhzt[k ;)
From this
village? ,e;j Ciur; nru;e;jtuh>
If yes,
HH ID,
Mk; vdpy;. FLk;g milahs vz; M
EM
BE
R I
D
cWg;gpdu; milahs vz
�4
41;
Caste
$hjp
Caste
Code
$hjp FwpaPL
Ed
uca
tion
cod
e g
iven
bel
ow
fy;;tp FwpaPL fPnH
bfhLf;fg;gl;Ls;sJ
Previously held
same post?
Kd;djhf mnj gjtpia tfpj;jhuh>
Candidate at last
GP election?
fle;j fpuhk g”;rhaj;J nju;jypy;
nghl;oapl;lhuh>
Member of
previous GP?
fle;j fpuhk g”;rhaj;jpd; cWg;gpduh>
Party affiliation
(Refer party
CODES] ve;j fl;rpa[ld; bjhlu;g[
cilatu; (fl;rp FwpaPLfis ghu;f;f)
M
M F
bg
Yes
Mk; No
,y;iy ����439
Yes
Mk; No
,y;iy
Yes
Mk; No
,y;iy Yes
Mk; No
,y;iy
Q.n
o 432. 433. 434. 435. 436. 437. 438. 439. 440. 441. 442. 443. 444.
1 President jiyth; 01 02 01 02 01 02
2 Clerk vGj;ju; 01 02 01 02 01 02 01 02 01 02
WARD ___
gFjp
3 Member 1
cWg;gpdh; 1
01 02
01 02
01 02 01 02 01 02
4 Member 2
cWg;gpdh; 2
01 02
01 02
01 02 01 02 01 02
5 Member 3
cWg;gpdh; 3
01 02
01 02
01 02 01 02 01 02
WARD____ gFjp
6 Member 1
cWg;gpdh; 1
01 02
01 02
01 02 01 02 01 02
7 Member 2
cWg;gpdh; 2
01 02
01 02
01 02 01 02 01 02
8 Member 3
cWg;gpdh; 3
01 02
01 02
01 02 01 02 01 02
WARD ____ gFjp
9 Member 1
cWg;gpdh; 1
01 02
01 02
01 02 01 02 01 02
10 Member 2
cWg;gpdh; 2
01 02
01 02
01 02 01 02 01 02
11 Member 3
cWg;gpdh; 3
01 02
01 02
01 02 01 02 01 02
Village Qustionnaire – Part B 72
Sl.
No. tupir vz;
Position
bghWg;g[
Name
bgau;
Gender
ghypdk;
Res
erv
atio
n?
[CO
DE
giv
en b
elo
w)
xJf;fPL FwpaPL (fPnH
fhzt[k ;)
From this
village? ,e;j Ciur; nru;e;jtuh>
If yes,
HH ID,
Mk; vdpy;. FLk;g milahs vz; M
EM
BE
R I
D
cWg;gpdu; milahs vz
�4
41;
Caste
$hjp
Caste
Code
$hjp FwpaPL
Ed
uca
tion
cod
e g
iven
bel
ow
fy;;tp FwpaPL fPnH
bfhLf;fg;gl;Ls;sJ
Previously held
same post?
Kd;djhf mnj gjtpia tfpj;jhuh>
Candidate at last
GP election?
fle;j fpuhk g”;rhaj;J nju;jypy;
nghl;oapl;lhuh>
Member of
previous GP?
fle;j fpuhk g”;rhaj;jpd; cWg;gpduh>
Party affiliation
(Refer party
CODES] ve;j fl;rpa[ld; bjhlu;g[
cilatu; (fl;rp FwpaPLfis ghu;f;f)
M
M F
bg
Yes
Mk; No
,y;iy ����439
Yes
Mk; No
,y;iy
Yes
Mk; No
,y;iy Yes
Mk; No
,y;iy
WARD ____
gFjp
12 Member 1
cWg;gpdh; 1
01 02
01 02
01 02 01 02 01 02
13 Member 2
cWg;gpdh; 2
01 02
01 02
01 02 01 02 01 02
14 Member 3
cWg;gpdh; 3
01 02
01 02
01 02 01 02 01 02
WARD ____
gFjp
15 Member 1
cWg;gpdh; 1
01 02
01 02
01 02 01 02 01 02
16 Member 2
cWg;gpdh; 2
01 02
01 02
01 02 01 02 01 02
17 Member 3
cWg;gpdh; 3
01 02
01 02
01 02 01 02 01 02
WARD ____ gFjp
18 Member 1
cWg;gpdh; 1
01 02
01 02
01 02 01 02 01 02
19 Member 2
cWg;gpdh; 2
01 02
01 02
01 02 01 02 01 02
20 Member 3
cWg;gpdh; 3
01 02
01 02
01 02 01 02 01 02
WARD ____ gFjp
21 Member 1
cWg;gpdh; 1
01 02
01 02
01 02 01 02 01 02
22 Member 2
cWg;gpdh; 2
01 02
01 02
01 02 01 02 01 02
23 Member 3
cWg;gpdh; 3
01 02
01 02
01 02 01 02 01 02
Village Qustionnaire – Part B 73
Reservation code
,lxJf;fPL FwpaPL
Options Code
SC Mjp jpuhtplu;
1
SC Female Mjp jpuhtplu; ? bgz;fs;
2
ST gH’;Foapdu;
3
ST Female gH’;Foapdu; ? bgz;fs;
4
BC / MBC gpd;j’;fpa tFg;g[ - kpft[k; gpd;j’;fpa tFg;g[
5
BC / MBC Female gpd;j’;fpa tFg;g[ - kpft[k; gpd;j’;fpa tFg;g[ ? bgz;fs;
6
Female bgz;fs; 7
Not Reserved xJf;fPL bra;ag;gltpy;;iy
8
Education code fy;tp FwpaPL
Options Code
No education gof;fhjtu; 1
Pre – school Muk;gg; gs;sp 2
Primary School only bjhlf;fg; gs;sp 3
Upper primary school only eLepiyg; gs;sp 4
Secondary/ Higher Secondary school only cau; epiy - nky; epiyg; gs;sp 5
College fy;Y}hp 6
Industrial Training bjhHpw; gapw;rp 7
Vocational Training ifj; bjhHpw; gapw;rp 8
Others (Specify) kw;wit (Fwpg;gplt[k;) 9
Village Qustionnaire – Part B 74
Details about gram panchayat (2001-2006): Note that the filled-in boxes for Panchayat President indicate information already collected in the election summary 2001 ?2006 fpuhk g”;rhaj;J gw;wpa tptu’;fs; Fwpg;g[ ? g”;rhajg”;rhajg”;rhajg”;rhaj;J jiytUf;fhf ;J jiytUf;fhf ;J jiytUf;fhf ;J jiytUf;fhf g{u;j;jp bra;ag;gl;Ls;s bgl;ofSf;F . njh;jy; bjhFg;gpy; ,Ue;J Vw;fdnt tptu’;fs; nrfupf;fg;gl;Ls;sd vd;gij ftdpf;ft[k; /
Sl.
No. tupir vz;
Position
bghWg;g[
Name
bgau;
Gender
ghypdk;
Res
erv
atio
n?
[CO
DE
giv
en b
elo
w)
xJf;fPL FwpaPL (fPbH
fhzt[k ;)
From this
village? ,e;j Ciur; nru;e;jtuh>
If yes,
HH ID,
Mk; vdpy;. FLk;g milahs vz
ME
MB
ER
ID
cWg;gpdu; milahs vz;
�4
54
;
Caste
$hjp
Caste
Code
$hjp FwpaPL
Ed
uca
tion
cod
e g
iven
bel
ow
fy;;tp FwpaPL fPnH
bfhLf;fg;gl;Ls;sJ
Previously held
same post?
Kd;djhf mnj gjtpia tfpj;jhuh>
Candidate at
last GP
election?
fle;j fpuhk g”;rhaj;J nju;jypy;
nghl;oapl;lhuh>
Member of
previous
GP?
fle;j fpuhk g”;rhaj;jpd; cWg;gpduh>
Party
affiliation
(Refer party
CODES] ve;j fl;rpa[ld; bjhlu;g[
cilatu; (fl;rp FwpaPLfis ghu;f;f)
M
M F
bg
Yes
Mk; No
,y;iy
�452
Yes
Mk; No
,y;iy Yes
Mk; No
,y;iy Yes
Mk; No
,y;iy
Q.no 445. 446. 447. 448. 449. 450. 451. 452. 453. 454. 455. 456. 457.
1 President jiyth;
01 02 01 02 01 02
2 Clerk vGj;ju; 01 02 01 02 01 02 01 02 01 02
WARD ___
gFjp
3 Member 1
cWg;gpdh; 1
01 02
01 02
01 02 01 02 01 02
4 Member 2
cWg;gpdh; 2
01 02
01 02
01 02 01 02 01 02
5 Member 3
cWg;gpdh; 3
01 02
01 02
01 02 01 02 01 02
WARD____ gFjp
6 Member 1
cWg;gpdh; 1
01 02
01 02
01 02 01 02 01 02
7 Member 2
cWg;gpdh; 2
01 02
01 02
01 02 01 02 01 02
8 Member 3
cWg;gpdh; 3
01 02
01 02
01 02 01 02 01 02
WARD ____ gFjp
9 Member 1
cWg;gpdh; 1
01 02
01 02
01 02 01 02 01 02
10 Member 2
cWg;gpdh; 2
01 02
01 02
01 02 01 02 01 02
11 Member 3
cWg;gpdh; 3
01 02
01 02
01 02 01 02 01 02
Village Qustionnaire – Part B 75
Sl.
No. tupir vz;
Position
bghWg;g[
Name
bgau;
Gender
ghypdk;
Res
erv
atio
n?
[CO
DE
giv
en b
elo
w)
xJf;fPL FwpaPL (fPbH
fhzt[k ;)
From this
village? ,e;j Ciur; nru;e;jtuh>
If yes,
HH ID,
Mk; vdpy;. FLk;g milahs vz
ME
MB
ER
ID
cWg;gpdu; milahs vz;
�4
54
;
Caste
$hjp
Caste
Code
$hjp FwpaPL
Ed
uca
tion
cod
e g
iven
bel
ow
fy;;tp FwpaPL fPnH
bfhLf;fg;gl;Ls;sJ
Previously held
same post?
Kd;djhf mnj gjtpia tfpj;jhuh>
Candidate at
last GP
election?
fle;j fpuhk g”;rhaj;J nju;jypy;
nghl;oapl;lhuh>
Member of
previous
GP?
fle;j fpuhk g”;rhaj;jpd; cWg;gpduh>
Party
affiliation
(Refer party
CODES] ve;j fl;rpa[ld; bjhlu;g[
cilatu; (fl;rp FwpaPLfis ghu;f;f)
M
M F
bg
Yes
Mk; No
,y;iy
�452
Yes
Mk; No
,y;iy Yes
Mk; No
,y;iy Yes
Mk; No
,y;iy
WARD ____
gFjp
12 Member 1
cWg;gpdh; 1
01 02
01 02
01 02 01 02 01 02
13 Member 2
cWg;gpdh; 2
01 02
01 02
01 02 01 02 01 02
14 Member 3
cWg;gpdh; 3
01 02
01 02
01 02 01 02 01 02
WARD ____
gFjp
15 Member 1
cWg;gpdh; 1
01 02
01 02
01 02 01 02 01 02
16 Member 2
cWg;gpdh; 2
01 02
01 02
01 02 01 02 01 02
17 Member 3
cWg;gpdh; 3
01 02
01 02
01 02 01 02 01 02
WARD ____
gFjp
18 Member 1
cWg;gpdh; 1
01 02
01 02
01 02 01 02 01 02
19 Member 2
cWg;gpdh; 2
01 02
01 02
01 02 01 02 01 02
20 Member 3
cWg;gpdh; 3
01 02
01 02
01 02 01 02 01 02
WARD ____ gFjp
21 Member 1
cWg;gpdh; 1
01 02
01 02
01 02 01 02 01 02
22 Member 2
cWg;gpdh; 2
01 02
01 02
01 02 01 02 01 02
23 Member 3
cWg;gpdh; 3
01 02
01 02
01 02 01 02 01 02
Village Qustionnaire – Part B 76
Reservation code
Options Code
SC Mjp jpuhtplu;
1
SC Female Mjp jpuhtplu; ? bgz;fs;
2
ST gH’;Foapdu;
3
ST Female gH’;Foapdu; ? bgz;fs;
4
BC / MBC gpd;j’;fpa tFg;g[ - kpft[k; gpd;j’;fpa tFg;g[
5
BC / MBC Female gpd;j’;fpa tFg;g[ - kpft[k; gpd;j’;fpa tFg;g[ ? bgz;fs;
6
Female bgz;fs; 7
Not Reserved ,l xJf;fPL ,y;iy
8
Education code
Options Code
No education gof;fhjtu; 1
Pre – school Muk;g gs;sp 2
Primary School only bjhlf;f gs;sp 3
Upper primary school only eLepiy gs;sp 4
Secondary/ Higher Secondary school only cau; epiy - nky; epiy gs;sp 5
College fy;Y}hp 6
Industrial Training bjhHpw; gapw;rp 7
Vocational Training ifj; bjhHpw; gapw;rp 8
Others (Specify) kw;wit (Fwpg;gplt[k;) 9
Village Qustionnaire – Part B 77
Revenue & expenditures: Current Panchayat tUkhdk;tUkhdk;tUkhdk;tUkhdk; & brytpd’;fs; ? jw;nghija g”;rhaj;Jbrytpd’;fs; ? jw;nghija g”;rhaj;Jbrytpd’;fs; ? jw;nghija g”;rhaj;Jbrytpd’;fs; ? jw;nghija g”;rhaj;J
458. Village Income and Expenditure Statement – 2004 to 2005 fpuhk tUkhdk; kw;Wk; brytpd’;fs; ml;ltiz ? 2004 ? 2005
Income tut[fs;[tut[fs;[tut[fs;[tut[fs;[ Rs. Ps. Expenses bryt[fs;bryt[fs;bryt[fs;bryt[fs; Rs. Ps.
1. House Tax tPl;L tup 1. Salary Cjpak;
2. Library Tax E}yf tup 2. Travel Conveyance gazg; go
3. Professional Tax bjhHpy; tup 3. Writing material vGJ bghUs;
4. Other taxes ,ju tup ,d’;fs; 4. Street Light – Electricity kpd; fl;lzk; ? bjU tpsf;Ffs;
5. Dangerous and offensive Trade
License fee
nfLk; jP’;Fk; tpistpf;fToa bjhHpy; chpkf; fl;lzk;
5. Motor Pumps – Electricity kpd; fl;lzk; ? tpirg; gk;g[fs;
6. Other Fee
,ju chpk fl;lzk;
6. Electricity - Panchayat Buildings
kpd; fl;lzk; ? Cuhl;rpapd; fl;ol’;fs;
7. Building / Plot License Fee
fl;olk; kw;Wk; kid gphpt[ cupkf; fl;lzk;
7. Maintenance of Wells - Materials
and Labour
fpzW guhkupg;g[ ? bghUl;fs; kw;Wk; Typ
8. Penalties paid to Panchayat
Cuhl;rpapy; tpjpf;fg;gl;l mguhj bjhif
8. Hand Pump maintenance
ifg; gk;g[fs; guhkupg;g[
9. Building lease
fl;ol Fj;jif
9. Water tanks - materials and
Labour
nky; epiy ePh; njf;fj; bjhl;o ? jiukl;l ePh;njf;fj; bjhl;o bghUl;fs; kw;Wk; Typ
10. Market (Shandy) Lease
re;ij Fj;jif
10. Maintenance of Street Lights -
Materials & Labour
bjU tpsf;Ffs; guhkupg;g[ ? bghUl;fs; kw;Wk; Typ
11. Income from Social Forestry /
Tree Tax ku kfNy; bjhif
11. Radio and TV - Materials &
Labour
thbdhyp kw;Wk; bjhiyf;fhl;rp ? bghUl;fs; kw;Wk;; Typ
12. Fishery Tax
kPd; ghrp Fj;jif
12. Public Sanitation - Materials &
labour
bghJ Rfhjhuk; ? bghUl;fs; kw;Wk; Typ
13. Other Leases
,ju tif Fj;jif
13. Social Forestry / Gardens
rK:f fhLfs;- gHj; njhl;l’;fs; - g{‘;fhf;fs;
14. Surcharge on Stamp paper Kj;jpiuj; jhs; kpF tup
14. Panchayat Tank Maintenance
Cuhl;rp Fs’;fs; guhkupg;g[
15. Entertainment Tax
nfspf;if tup
15. Recognised Festival Expenses
m';fPfupf;fg;gl;l jpUtpHh brytpd’;fs; [
16. Head tax jy thp 16. Panchayat Building Maintenance
Cuhl;rp fl;ol guhkupg;g[
17. 2C Tree Tax ku tup (2C gl;lh fl;fzk;)
17. Maintenance of Tools jsthl rhkhd;fs; guhkupg;g[
18. Criminal Penalties Collection
Fw;wtpay; jz;l tNy;
18. Road / Minor Bridges
maintenance rhiyfs; -rpW ghy’;fs; guhkupg;g[
19. Other income from Funds
Allocated ,ju xJf;fg;gl;l epjp tutpdk;
19. Panchayat cremation ground
maintenance
Cuhl;rpapd; RLfhL guhkupg;g[
Village Qustionnaire – Part B 78
Income tut[fs;[tut[fs;[tut[fs;[tut[fs;[ Rs. Ps. Expenses bryt[fs;bryt[fs;bryt[fs;bryt[fs; Rs. Ps.
20. Deposit
itg;g[j; bjhif 20. Library tax – Repaid E}yf tup ? jpUk;g mspj;jy;
21. Matured Deposits
fhyk; fle;j itg;g[j; bjhif
21. Paying off deposits itg;g[ bjhif jpUk;g mspj;jy;
22. State Finance Commission
Subsidy (without condition)
khepy epjp FG khdpak; ( epge;jid ,y;yhj gFjp )
22. Cash Advances
Kd; gzk; tH’;Fjy;
23. Other Subsidies
,ju khdpa’;fs; 23. Miscellaneous expenses
,jur; bryt[fs;
24. Others Specify
_______________________ kw;wit Fwpg;gplt[k;
24. Construction of New Buildings
g[jpa fl;ol’;fs; mikj;jy;
25. Others Specify
__________________ kw;wit Fwpg;gplt[k;
25. Laying of New roads / road
development
g[jpa rhiy mikj;jYk; - nkk;ghL bra;jYk;
26. Others Specify
__________________ kw;wit Fwpg;gplt[k;
26. Construction of New Minor
bridges
g[jpa rpW ghy’;fs; mikj;jy;
27. Others Specify
__________________________ kw;wit Fwpg;gplt[k;
27. Street Light – Extension
bjU tpsf;F tpupt[gLj;Jjy;
28. Others Specify
___________________________ kw;wit Fwpg;gplt[k;
28. Water Pipe – Extension
FoePh; FHha;fs; tphpt[gLj;Jjy;
29. Provision of New Drinking water
facility
g[jpa FoePu; rhjd’;fs; mikj;jy;
30. Purchase of Tools / implements
g[jpa jsthl rhkhd;fs; th’;Fjy;
31. Deposits by Panchayat
Cuhl;rpahy; bra;ag;gLk; KjyPLfs;
32. Other Investment Expenses
,ju K:yjd brytpd’;fs;
33. Others Specify
________________________ kw;wit Fwpg;gplt[k;
34. Others Specify
______________________ kw;wit Fwpg;gplt[k;
35. Others Specify
_______________________ kw;wit Fwpg;gplt[k;
36. Others Specify
______________________ kw;wit Fwpg;gplt[k;
37. Others Specify
_______________________ kw;wit Fwpg;gplt[k;
Total bkhj;jk;
Total bkhj;jk;
in hand/bank ifapUg;g[ - t’;fpapy; ,Ug;g[
in hand/bank ifapUg;g[ - t’;fpapy; ,Ug;g[
Gross Total bgU bkhj;jk;
Gross Total bgU bkhj;jk;
Village Qustionnaire – Part B 79
459. Government Grants, Plan Funds, Namathu Gramam, etc – 2004 to 2005 murh’;f rYiffs;. jpl;l xJf;fPL. ekJ fpuhkk;. ,ju ? 2004?2005
S.no Income tUkhdk;tUkhdk;tUkhdk;tUkhdk; Rs.
1. Government Grants - Subject to Conditions
epge;jidf;F cl;gl;l muR khdpa’;fs; epjp (11 / 12
th Finance Commission Fund 11 / 12 tJ epjpf;FG khdpak;)
2. State Finance Commission Fund
khepy epjpf;FG khdpak; (epge;jidf;F cl;gl;lJ ) 3. Plan Fund (SGRY, PMGRY, Indira Memorial Housing Plan & OTHER PLAN FUNDS)
jpl;l epjp (,e;jpuh epidt[ FoapUg;g[ jpl;lk;. kw;w jpl;l epjp)
4. Drinking water plan
FoePu; jpl;lk;
5. Namathu Gramam (Our Village)
ekJ fpuhkk;
6. Other Plans / Projects ,ju jpl;;lk; ______________________________
7. Other Plans / Projects ,ju jpl;;lk; ______________________________
8. Other Plans / Projects ,ju jpl;;lk; ______________________________
9. Other Plans / Projects ,ju jpl;;lk; ______________________________
10. Other Plans / Projects ,ju jpl;;lk; ______________________________
11. Other Plans / Projects ,ju jpl;;lk; ______________________________
12. Other Plans / Projects ,ju jpl;;lk; ______________________________
13. Other Plans / Projects ,ju jpl;;lk; ______________________________
14. Other Plans / Projects ,ju jpl;;lk; ______________________________
15. Other Plans / Projects ,ju jpl;;lk; ______________________________
Village Qustionnaire – Part B 80
460. Village Income and Expenditure Statement – 2005 to 2006 fpuhk tUkhdk; kw;Wk; brytpd’;fs; ml;ltiz ? 2005?2006
Income tut[fs;[tut[fs;[tut[fs;[tut[fs;[ Rs. Ps. Expenses bryt[fs;bryt[fs;bryt[fs;bryt[fs; Rs. Ps.
1. House Tax tPl;L tup 1. Salary Cjpak;
2. Library Tax E}yf tup 2. Travel Conveyance gazg; go
3. Professional Tax bjhHpy; tup 3. Writing material vGJ bghUs;
4. Other taxes ,ju tup ,d’;fs; 4. Street Light – Electricity
kpd; fl;lzk; ? bjU tpsf;Ffs;
5. Dangerous and offensive Trade
License fee
nfLk; jP’;Fk; tpistpf;fToa bjhHpy; chpkf; fl;lzk;
5. Motor Pumps – Electricity kpd; fl;lzk; ? tpirg; gk;g[fs;
6. Other Fee
,ju chpkf; fl;lzk;
6. Electricity - Panchayat Buildings
kpd; fl;lzk; ? Cuhl;rpapd; fl;ol’;fs;
7. Building / Plot License Fee
fl;olk; kw;Wk; kid gphpt[ cupkf; fl;lzk;
7. Maintenance of Wells - Materials
and Labour
fpzW guhkupg;g[ ? bghUl;fs; kw;Wk; Typ
8. Penalties paid to Panchayat
Cuhl;rpapy; tpjpf;fg;gl;l mguhj bjhif
8. Hand Pump maintenance
ifg; gk;g[fs; guhkupg;g[
9. Building lease fl;ol bjhif
9. Water tanks - materials and
Labour
nky; epiy ePh; njf;fj; bjhl;o ? jiukl;l ePh;njf;fj; bjhl;o bghUl;fs; kw;Wk; Typ
10. Market (Shandy) Lease
re;ijf; Fj;jif
10. Maintenance of Street Lights -
Materials & Labour
bjU tpsf;Ffs; guhkupg;g[ ? bghUl;fs; kw;Wk; Typ
11. Income from Social Forestry /
Tree Tax ku kfNy; bjhif
11. Radio and TV - Materials &
Labour
thbdhyp kw;Wk; bjhiyf;fhl;rp ? bghUl;fs; kw;Wk;; Typ
12. Fishery Tax kPd; ghrp Fj;jif
12. Public Sanitation - Materials &
labour
bghJ Rfhjhuk; ? bghUl;fs; kw;Wk; Typ
13. Other Leases ,ju tif Fj;jif
13. Social Forestry / Gardens
rK:f fhLfs;- gHj; njhl;l’;fs; - g{‘;fhf;fs;
14. Surcharge on Stamp paper Kj;jpiuj; jhs; kpF thp
14. Panchayat Tank Maintenance
Cuhl;rp Fs’;fs; guhkupg;g[
15. Entertainment Tax
nfspf;if tup
15. Recognised Festival Expenses
m';fPfupf;fg;gl;l jpUtpHh brytpd’;fs; [
16. Head tax jy thp 16. Panchayat Building Maintenance
Cuhl;rp fl;ol guhkupg;g[
17. 2C Tree Tax ku tup; (2C gl;lh fl;lzk;)
17. Maintenance of Tools
jsthl rhkhd;fs; guhkupg;g[
18. Criminal Penalties Collection
Fw;wtpay; jz;l tNy;
18. Road / Minor Bridges
maintenance rhiyfs; -rpW ghy’;fs; guhkupg;g[
19. Other income from Funds
Allocated
,ju xJf;fg;gl;l epjp tutpdk;
19. Panchayat cremation ground
maintenance
Cuhl;rpapd; RLfhL guhkupg;g[
20. Deposit
itg;g[j; bjhif 20. Library tax – Repaid
E}yf tup ? jpUk;g mspj;jy;
Village Qustionnaire – Part B 81
Income tut[fs;[tut[fs;[tut[fs;[tut[fs;[ Rs. Ps. Expenses bryt[fs;bryt[fs;bryt[fs;bryt[fs; Rs. Ps.
21. Matured Deposits
fhyk; fle;j itg;g[j; bjhif
21. Paying off deposits
itg;gj;[ bjhif jpUk;g mspj;jy;
22. State Finance Commission
Subsidy (without condition)
khepy epjpf; FG khdpak; ( epge;jid ,y;yhj gFjp )
22. Cash Advances
Kd; gzk; tH’;Fjy;
23. Other Subsidies
,ju khdpa’;fs; 23. Miscellaneous expenses
,jur; bryt[fs;
24. Others Specify
_______________________ kw;wit Fwpg;gplt[k;
24. Construction of New Buildings
g[jpa fl;ol’;fs; mikj;jy;
25. Others Specify
__________________ kw;wit Fwpg;gplt[k;
25. Laying of New roads / road
development
g[jpa rhiy mikj;jYk; - nkk;ghL bra;jYk;
26. Others Specify
_____________________ kw;wit Fwpg;gplt[k;
26. Construction of New Minor
bridges
g[jpa rpW ghy’;fs; mikj;jy;
27. Others Specify
__________________________ kw;wit Fwpg;gplt[k;
27. Street Light – Extension
bjU tpsf;F tpupt[gLj;Jjy;
28. Others Specify
___________________________ kw;wit Fwpg;gplt[k;
28. Water Pipe – Extension
FoePu;f; FHha;fs; tphpt[gLj;Jjy;
29. Provision of New Drinking water
facility
g[jpa FoePu; rhjd’;fs; mikj;jy;
30. Purchase of Tools / implements
g[jpa jsthlr; rhkhd;fs; th’;Fjy;
31. Deposits by Panchayat
Cuhl;rpahy; bra;ag;gLk; KjyPLfs;
32. Other Investment Expenses
,ju K:yjd brytpd’;fs;
33. Others Specify
________________________ kw;wit Fwpg;gplt[k;
34. Others Specify
______________________ kw;wit Fwpg;gplt[k;
35. Others Specify
_______________________ kw;wit Fwpg;gplt[k;
36. Others Specify
______________________ kw;wit Fwpg;gplt[k;
37. Others Specify
_______________________ kw;wit Fwpg;gplt[k;
Total bkhj;jk;
Total bkhj;jk;
in hand/bank ifapUg;g[ - t’;fpapy; ,Ug;g[
in hand/bank ifapUg;g[ - t’;fpapy; ,Ug;g[
Gross Total bgU bkhj;jk;
Gross Total bgU bkhj;jk;
Village Qustionnaire – Part B 82
461. Government Grants, Plan Funds, Namathu Gramam, etc – 2005 to 2006 murh’;f rYiffs;. jpl;l xJf;fPL. ekJ fpuhkk;. ,ju ? 2005?2006
S.no Income tUkhdk;tUkhdk;tUkhdk;tUkhdk; Rs.
1. Government Grants - Subject to Conditions
epge;jidf;F cl;gl;l muR khdpa’;fs; epjp (11 / 12
th Finance Commission Fund 11 / 12 tJ epjpf;FG khdpak;)
2. State Finance Commission Fund
khepy epjpf;FG khdpak; (epge;jidf;F cl;gl;lJ ) 3. Plan Fund (SGRY, PMGRY, Indira Memorial Housing Plan & OTHER PLAN FUNDS)
jpl;l epjp (,e;jpuh epidt[ FoapUg;g[ jpl;lk;. kw;w jpl;l epjp)
4. Drinking water plan
FoePu; jpl;lk;
5. Namathu Gramam (Our Village)
ekJ fpuhkk;
6. Other Plans / Projects ,ju jpl;;lk; ______________________________
7. Other Plans / Projects ,ju jpl;;lk; ______________________________
8. Other Plans / Projects ,ju jpl;;lk; ______________________________
9. Other Plans / Projects ,ju jpl;;lk; ______________________________
10. Other Plans / Projects ,ju jpl;;lk; ______________________________
11. Other Plans / Projects ,ju jpl;;lk; ______________________________
12. Other Plans / Projects ,ju jpl;;lk; ______________________________
13. Other Plans / Projects ,ju jpl;;lk; ______________________________
14. Other Plans / Projects ,ju jpl;;lk; ______________________________
15. Other Plans / Projects ,ju jpl;;lk; ______________________________
Village Qustionnaire – Part B 83
462. Village Income and Expenditure Statement – 2006 to 2007 fpuhk tUkhdk; kw;Wk; brytpd’;fs; ml;ltiz ? 2006?2007
Income tut[fs;[tut[fs;[tut[fs;[tut[fs;[ Rs. Ps. Expenses bryt[fs;bryt[fs;bryt[fs;bryt[fs; Rs. Ps.
1. House Tax tPl;L tup 1. Salary Cjpak;
2. Library Tax E}yf tup 2. Travel Conveyance gazg; go
3. Professional Tax bjhHpy; tup 3. Writing material vGJ bghUs;
4. Other taxes ,ju tup ,d’;fs; 4. Street Light – Electricity
kpd; fl;lzk; ? bjU tpsf;Ffs;
5. Dangerous and offensive Trade
License fee
nfLk; jP’;Fk; tpistpf;fToa bjhHpy; chpkf; fl;lzk;
5. Motor Pumps – Electricity kpd; fl;lzk; ? tpirg; gk;g[fs;
6. Other Fee
,ju chpk fl;lzk;
6. Electricity - Panchayat
Buildings kpd; fl;lzk; ? Cuhl;rpapd; fl;ol’;fs;
7. Building / Plot License Fee
fl;olk; kw;Wk; kid gphpt[ cupkf; fl;lzk;
7. Maintenance of Wells -
Materials and Labour
fpzW guhkupg;g[ ? bghUl;fs; kw;Wk; Typ
8. Penalties paid to Panchayat
Cuhl;rpapy; tpjpf;fg;gl;l mguhj bjhif
8. Hand Pump maintenance
ifg; gk;g[fs; guhkupg;g[
9. Building lease fl;ol bjhif
9. Water tanks - materials and
Labour
nky; epiy ePh; njf;fj; bjhl;o ? jiukl;l ePh;njf;fj; bjhl;o bghUl;fs; kw;Wk; Typ
10. Market (Shandy) Lease
re;ij Fj;jif
10. Maintenance of Street Lights -
Materials & Labour
bjU tpsf;Ffs; guhkupg;g[ ? bghUl;fs; kw;Wk; Typ
11. Income from Social Forestry /
Tree Tax ku kfNy; bjhif
11. Radio and TV - Materials &
Labour
thbdhyp kw;Wk; bjhiyf;fhl;rp ? bghUl;fs; kw;Wk;; Typ
12. Fishery Tax kPd; ghrp Fj;jif
12. Public Sanitation - Materials &
labour
bghJ Rfhjhuk; ? bghUl;fs; kw;Wk; Typ
13. Other Leases ,ju tif Fj;jif
13. Social Forestry / Gardens
rK:f fhLfs;- gHj; njhl;l’;fs; - g{‘;fhf;fs;
14. Surcharge on Stamp paper Kj;jpiuj; jhs; kpF thp
14. Panchayat Tank Maintenance
Cuhl;rp Fs’;fs; guhkupg;g[
15. Entertainment Tax
nfspf;if tup
15. Recognised Festival Expenses
m';fPfupf;fg;gl;l jpUtpHh brytpd’;fs; [
16. Head tax jy thp
16. Panchayat Building
Maintenance
Cuhl;rp fl;ol guhkupg;g[
17. 2C Tree Tax ku tup; (2C gl;lh fl;lzk;)
17. Maintenance of Tools
jsthl rhkhd;fs; guhkupg;g[
18. Criminal Penalties Collection
Fw;wtpay; jz;l tNy;
18. Road / Minor Bridges
maintenance rhiyfs; -rpW ghy’;fs; guhkupg;g[
19. Other income from Funds
Allocated ,ju xJf;fg;gl;l epjp tutpdk;
19. Panchayat cremation ground
maintenance
Cuhl;rpapd; RLfhL guhkupg;g[
20. Deposit itg;g[j; bjhif 20. Library tax – Repaid
E}yf tup ? jpUk;g mspj;jy;
Village Qustionnaire – Part B 84
Income tut[fs;[tut[fs;[tut[fs;[tut[fs;[ Rs. Ps. Expenses bryt[fs;bryt[fs;bryt[fs;bryt[fs; Rs. Ps.
21. Matured Deposits
fhyk; fle;j itg;g[j; bjhif
21. Paying off deposits
itg;g[ bjhif jpUk;g mspj;jy;
22. State Finance Commission
Subsidy (without condition)
khepy epjp FG khdpak; ( epge;jid ,y;yhj gFjp )
22. Cash Advances
Kd; gzk; tH’;Fjy;
23. Other Subsidies
,ju khdpa’;fs; 23. Miscellaneous expenses
,jur; bryt[fs;
24. Others Specify
_______________________ kw;wit Fwpg;gplt[k;
24. Construction of New
Buildings
g[jpa fl;ol’;fs; mikj;jy;
25. Others Specify
__________________ kw;wit Fwpg;gplt[k;
25. Laying of New roads / road
development
g[jpa rhiy mikj;jYk; - nkk;ghL bra;jYk;
26. Others Specify
___________ kw;wit Fwpg;gplt[k;
26. Construction of New Minor
bridges
g[jpa rpW ghy’;fs; mikj;jy;
27. Others Specify
__________________________ kw;wit Fwpg;gplt[k;
27. Street Light – Extension
bjU tpsf;F tpupt[gLj;Jjy;
28. Others Specify
___________________________ kw;wit Fwpg;gplt[k;
28. Water Pipe – Extension
FoePu;f; FHha;fs; tphpt[gLj;Jjy;
29. Provision of New Drinking
water facility
g[jpa FoePu; rhjd’;fs; mikj;jy;
30. Purchase of Tools /
implements
g[jpa jsthl rhkhd;fs; th’;Fjy;
31. Deposits by Panchayat
Cuhl;rpahy; bra;ag;gLk; KjyPLfs;
32. Other Investment Expenses
,ju K:yjd brytpd’;fs;
33. Others Specify
________________________ kw;wit Fwpg;gplt[k;
34. Others Specify
______________________ kw;wit Fwpg;gplt[k;
35. Others Specify
_______________________ kw;wit Fwpg;gplt[k;
36. Others Specify
______________________ kw;wit Fwpg;gplt[k;
37. Others Specify
_______________________ kw;wit Fwpg;gplt[k;
Total bkhj;jk;
Total bkhj;jk;
in hand/bank ifapUg;g[ - t’;fpapy; ,Ug;g[
in hand/bank ifapUg;g[ - t’;fpapy; ,Ug;g[
Gross Total bgU bkhj;jk;
Gross Total bgU bkhj;jk;
Village Qustionnaire – Part B 85
463. Government Grants, Plan Funds, Namathu Gramam, etc – 2006 to 2007 murh’;f rYiffs;. jpl;l xJf;fPL. ekJ fpuhkk;. ,ju ? 2006?2007
S.no Income tUkhdk;tUkhdk;tUkhdk;tUkhdk; Rs.
1. Government Grants - Subject to Conditions
epge;jidf;F cl;gl;l muR khdpa’;fs; epjp (11 / 12
th Finance Commission Fund 11 / 12 tJ epjpf;FG khdpak;)
2. State Finance Commission Fund
khepy epjpf;FG khdpak; (epge;jidf;F cl;gl;lJ ) 3. Plan Fund (SGRY, PMGRY, Indira Memorial Housing Plan & OTHER PLAN FUNDS)
jpl;l epjp (,e;jpuh epidt[ FoapUg;g[ jpl;lk;. kw;w jpl;l epjp)
4. Drinking water plan
FoePu;;j; jpl;lk;
5. Namathu Gramam (Our Village)
ekJ fpuhkk;
6. Other Plans / Projects ,ju jpl;;lk; ______________________________
7. Other Plans / Projects ,ju jpl;;lk; ______________________________
8. Other Plans / Projects ,ju jpl;;lk; ______________________________
9. Other Plans / Projects ,ju jpl;;lk; ______________________________
10. Other Plans / Projects ,ju jpl;;lk; ______________________________
11. Other Plans / Projects ,ju jpl;;lk; ______________________________
12. Other Plans / Projects ,ju jpl;;lk; ______________________________
13. Other Plans / Projects ,ju jpl;;lk; ______________________________
14. Other Plans / Projects ,ju jpl;;lk; ______________________________
15. Other Plans / Projects ,ju jpl;;lk; ______________________________
Village Qustionnaire – Part B 86
Nature of work done in the street /colony / Neighbourhoods CURRENT PANCHAYAT Oct 2006-current
rhiy - FoapUg;g[ - mUfhik ,l’;fspy; bra;ag;gl;l ntiyapd; jd;ik ? elg;g[ g”;rhaj;J mf;nlhgu; 2006 elg;g[ (Work undertaken from Oct 2006 to ___________________ [today’s date: dd/mm/YYYY]- either providing the service OR
developing new facility / service OR maintenance activity)
mf;nlhgu; 2006 Kjy; ???????????????????????? nkw;bfhs;sg;gl;l ntiyfs; ( ,d;iwa njjp ehs;-khjk;-tUlk;) ? nrit tH’;Ftjw;fhfnth my;yJ g[jpa trjpfs;- nritfis nkk;gLj;jnth my;yJ guhkupg;g[ ntiyfSf;fhfnth)
Type of Work
ntiyapd; jd;ik
Was this
[TYPE OF
WORK]
undertaken in
this Village
from Oct 2006
to till date? mf;nlhgu; 2006ypUe;J ,d;Wtiu nkw;bfhs;sg;gl;l ,e;j ntiy ,e;j fpuhkj;jpy; eil bgw;wjh>
01 = Yes
Mk; 02 = No
,y;iy
If yes,
what
kind of
work
took
place?
Mk; vdpy;. ve;j tifahd ntiy eilbghw;wJ
01=
new
facility
or
service
01 = g[jpa trjp my;yJ nrit 02=
maint-
enance
02 guhkupg;g[
03=both
03= ,uz;Lk;
Where did the work take place? ,e;j ntiy v’;F eilbgw;wJ> Was that provision / development of new facility / service or maintenance activity? mJ g[jpa trjpfs;-nritfis nkk;gLj;Jtjw;fhdjh-my;yJ guhkupg;g[ eltof;ifah> 01 = Yes, new facility / service developed; 01=Mk;. g[jpa trjpfs;-nritfs; nkk;gLj;jg;gl;lJ 02 = Yes, maintenance activity taken place; 02=Mk;. guhkupg;g[ eltof;iffs; bray;gLj;jg;gl;ld 03 = Both - new facility / service developed & maintenance activity taken place 03=Mk;. ,uz;Lk; g[jpa trjpfs;-nritfis nkk;gLj;j kw;Wk; guhkupg;g[ eltof;iffs; Street-Neighborhood ID
gzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahsgzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahsgzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahsgzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahs vz;vz;vz;vz;
ST
RE
ET
ID
1
bjU milahs vz; 1
ST
RE
ET
ID
2
bjU milahs vz; 2
S
TR
EE
T I
D3
bjU milahs vz; 3
S
TR
EE
T I
D4
bjU milahs vz; 4
S
TR
EE
T I
D5
bjU milahs vz; 5
S
TR
EE
T I
D6
bjU milahs vz; 6
S
TR
EE
T I
D7
bjU milahs vz; 7
Q.no 464. 465. 466.
1. Purity of drinking water
Fo jz;zPiuj; J}a;ikg; gLj;JtJ
2. Supply of drinking water
FoePu; tpepnahfk;
3. Sanitation/ sewage
Rfhjhuk;-fHpt[ ePufw;WtJ
4. Roads
rhiy mikg;gJ
5. Communication Facilities
(e.g. PCO, Post office)
jfty; bjhlu;g[ trjpfs; (ck; gprpX. m”;ry; epiyak;)
6. Local Transport
cs;S:u; nghf;F tuj;J
7. School quality and access
[building schools,
improvement, painting, etc]
gs;spf;Tlj;jpd; juk; kw;Wk; nkk;gLj;Jjy; (gs;spf;Tl’;fs; fl;Ljy; . trjpfis nkk;gLj;Jjy; bgapd;o’; nghd;wit)
8. Health Mnuhf;fpak;
9. Childcare or child facility,
including balwadi
FHe;;ijfs; guhkupg;g[. my;yJ FHe;ijf;fhd trjpfs; . ghy;tho cl;gl
Village Qustionnaire – Part B 87
Type of Work
ntiyapd; jd;ik
Was this
[TYPE OF
WORK]
undertaken in
this Village
from Oct 2006
to till date? mf;nlhgu; 2006ypUe;J ,d;Wtiu nkw;bfhs;sg;gl;l ,e;j ntiy ,e;j fpuhkj;jpy; eil bgw;wjh>
01 = Yes
Mk; 02 = No
,y;iy
If yes,
what
kind of
work
took
place?
Mk; vdpy;. ve;j tifahd ntiy eilbghw;wJ
01=
new
facility
or
service
01 = g[jpa trjp my;yJ nrit 02=
maint-
enance
02 guhkupg;g[
03=both
03= ,uz;Lk;
Where did the work take place? ,e;j ntiy v’;F eilbgw;wJ> Was that provision / development of new facility / service or maintenance activity? mJ g[jpa trjpfs;-nritfis nkk;gLj;Jtjw;fhdjh-my;yJ guhkupg;g[ eltof;ifah> 01 = Yes, new facility / service developed; 01=Mk;. g[jpa trjpfs;-nritfs; nkk;gLj;jg;gl;lJ 02 = Yes, maintenance activity taken place; 02=Mk;. guhkupg;g[ eltof;iffs; bray;gLj;jg;gl;ld 03 = Both - new facility / service developed & maintenance activity taken place 03=Mk;. ,uz;Lk; g[jpa trjpfs;-nritfis nkk;gLj;j kw;Wk; guhkupg;g[ eltof;iffs; Street-Neighborhood ID
gzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahsgzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahsgzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahsgzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahs vz;vz;vz;vz;
ST
RE
ET
ID
1
bjU milahs vz; 1
ST
RE
ET
ID
2
bjU milahs vz; 2
S
TR
EE
T I
D3
bjU milahs vz; 3
S
TR
EE
T I
D4
bjU milahs vz; 4
S
TR
EE
T I
D5
bjU milahs vz; 5
S
TR
EE
T I
D6
bjU milahs vz; 6
S
TR
EE
T I
D7
bjU milahs vz; 7
10. Housing-[Subsidised / Free
house construction or
improvement/ maintenance,
slum upgradation]
tPl;L trjp ? (khdpak; tH’;FtJ-,ytrkhf tPL fl;oj; jUtJ my;yJ trjpfis nkk;gLj;JtJ . Foirfisj; juk; cau;j;Jjy; nghd;wd)
11. Irrigation facilities / Public
Irrigation Facilities
(Construction / Maintenance
/ Improvement)
ghrd trjpfs;-bghJ ePu;g;ghrd trjpfs; (fl;Lkhdk;-guhkupg;g[-nkk;gLj;Jjy;)
12. Water harvesting
ePu; tsj;ij nkk;gLj;Jjy;
13. canals (Cleaning /
construction / improvement)
tha;f;fhy;fs; (Rj;jg;gLj;jy; -fl;Lkhdk;- nkk;gLj;jy;)
14. Electrification/Electric
supply
kpd; ,izg;g[f;fs; tH’;FtJ - kpd; tpdpnahfk;
15. Street Light
bjU tpsf;F
Village Qustionnaire – Part B 88
Details of the previous two gram sabhas held in the village
Kd;djhf fpuhkj;jpy; Kd;djhf fpuhkj;jpy; Kd;djhf fpuhkj;jpy; Kd;djhf fpuhkj;jpy; eilbgw;w eilbgw;w eilbgw;w eilbgw;w ,uz;L fpuhk rghf;fspd; tptu’;fs;,uz;L fpuhk rghf;fspd; tptu’;fs;,uz;L fpuhk rghf;fspd; tptu’;fs;,uz;L fpuhk rghf;fspd; tptu’;fs; Q.
no Details tptu’;fstptu’;fstptu’;fstptu’;fs; ; ; ;
Last Gram
sabha
filrp fpuhk rig
Previous
Gram sabha
Ke;ija fpuhk rig
467. When was the meeting held?
Tl;lk; vg;nghJ eilbgw;wJ> Year YYYY
tUlk; ???????
Month
khjk;
468. What time did the meeting begin?
Tl;lk;; ve;j neuj;jpy; bjhl';fpaJ> Time neuk;
469. Where did the meeting take place?
Tl;lk;; v’;nf ele;jJ> Under a tree kuj;joapy;
01 01
In a School gs;spapy;
02 02
In the Panchayat Office g”;rhaj;J mYtyfj;jpy;
03 03
In the Temple nfhapypy;
04 04
President’s house jiytu; tPl;oy;
05 05
SHG’S building Ra cjtpf; FG fl;olj;jpy;
06 06
VAO Office fpuhk epu;thf mYtyu; mYtyfj;jpy;
07 07
Other place [Specify] ________
kw;wit (Fwpg;gplt[k;)
08 08
470. Duration of meeting (minutes)
Tl;lk; vt;tst[ neuk; eilbgw;wJ (epkpl’;fs;) 471. How long in advance of the meeting was it announced to the public? (DAYS)
Tl;lk; elg;gjw;F . vj;jid ehl;fSf;F Kd;djhf bghJkf;fSf;F mwptpf;fg;gl;lJ> (ehl;fs;)
472. How was it announced to the public?
(code all applicable)
mJ bghJkf;fSf;F vg;go mwptpf;fg;gl;lJ> (bghUe;Jtd midj;ija[k; Fwpf;ft[k;)
Village / ward notice board
fpuhkk; - thu;L mwptpg;g[g; gyif 01 01
Public announcement (megaphone)
bghJ mwptpg;g[ (bkfh`nghd;) 02 02
Beating drums / tom tom
jz;nlhuh-lhk; lhk; 03 03
Pamphlet
gpuRuk; 04 04
Newspaper/magazine
bra;jpjhs; - gj;jpupiffs;; 05 05
Radio/TV
thbdhyp - bjhiyf;fhl;rp 06 06
Govt. official/GP secretary (clerk)
muR mYtyu; - fpuhk g”;rhaj;J brayhsu; (vGj;ju;)
07 07
Panchayat President/ Vice President
/ Ward member
g”;rhaj;J jiytu; - Jizj; jiytu; - thu;L cWg;gpdu;
08 08
Party worker
murpay; fl;rpf;fhf ntiy bra;gtu;fs; 09 09
Other community leader
kw;w rKjha jiytu;fs; 10 10
NGO / Community Organization
muRrhuh bjhz;L epWtd’;fs;-rKjha epWtd’;fs;
11 11
Other (Specify)
kw;wit (Fwpg;gpLf) 12 12
Village Qustionnaire – Part B 89
Q.
no Details tptu’;fstptu’;fstptu’;fstptu’;fs; ; ; ;
Last Gram
sabha
filrp fpuhk rig
Previous
Gram sabha
Ke;ija fpuhk rig
473. Who chaired the meeting?
Tl;lj;jpw;F ahu; jiyik jh’;fpdhu;fs;> GP President fpuhk g”;rhaj;J jiytu; 01 01
President's spouse jiytupd; Jiztu;
02 02
Other member of President's family jiytupd; FLk;gj;jpYs;s kw;w cWg;gpdu;
03 03
GP Clerk fpuhk g”;rhaj;J vGj;ju; 04 04
GP Vice President fpuhk g”;rhaj;J Jizj;jiytu;
05 05
Other GP member kw;w fpuhk g”;rhaj;J cWg;gpdu;
06 06
Higher Panchayat Members (like
councilor, Union Chairman, etc) cau;epiy g”;rhaj;J cWg;gpdu;fs; (ft[d;rpyu;. xd;wpa jiytu;fs; nghd;wtu;fs;)
07 07
Higher panchayat Government official (Block or
District level official)
cau;epiy g”;rhaj;J murh’;f mYtyu;fs; (tl;lk; my;yJ khtl;l mstpy;)
08 08
Other influential person in the village fpuhkj;jpy; cs;s ,ju bry;thf;F cs;s kdpju;fs;
09 09
Others (Specify) kw;wit (Fwpg;gplt[k;)
10 10
474. Number of panchayat members attended
Tl;lj;jpw;F tUif je;j g”;rhaj;J cWg;gpdu;fspd; vz;zpf;if
475. Number of citizens attended
Tl;lj;jpw;F tUif je;j Fokf;fspd; vz;zpf;if
476. Number of those in attendance who were female
tUif je;jtu;fspy; bgz;fspd; vz;zpf;if
477. Number of those in attendance who were from SC
tUif je;jtu;fspy;; jhH;j;jg;gl;l rK:fj;jpdupd; vz;zpf;if
478. Number of those in attendance who were from a ST tUif je;jtu;fspy;; gH';Fo rK:fj;jpdupd; vz;zpf;if
479. Number of higher level government officials attending
tUif je;jtu;fspy; murh’;f caujpfhupfspd; vz;zpf;if
480. 3 MOST IMPORTANT
ISSUES DISCUSSED/
DECISIONS TAKEN *
3 Kf;fpa gpur;rpidfs; fye;jhnyhrpf;fg;gl;lJ-Kot[ vLf;fg;gl;lJ DECISION codes:
jPu;khd FwpaPL
01 = secret ballot0
02 = show of hands
03 = voice vote
04=convener decided
05=president decided
06=ward members decided
later
07=no vote
*discussed for the longest
time
01=,ufrpa thf;bfLg;g[ 02=iffis cau;j;Jjy; 03=Fuy; thf;bfLg;g[ 04=rig elj;Jgtu; Kot[ bra;jhu; 05=jiytu; Kot[ bra;jhu;; 06=thu;L cWg;gpdu;fs; gpd;du; jPu;khdpj;jdu; 07=thf;bfLg;g[ ,y;iy *mjpf neuk; fye;Jiuahodhh;fs;
Most
important
Issue
kpf Kf;fpakhd gpur;rpid
Issue [WRITE EXACTLY]
gpur;rpid ? (brhy ;tij mg ;gona vGJf)
Issue (code given below)
gpur;rpid (FwpaPL)
vote type
Xl;od; tif
Second most
important
Issue ,uz;lhtJ Kf;fpakhd gpur;rpid
Issue [WRITE EXACTLY]
gpur;rpid ? (brhy ;tij mg ;gona vGJf)
Issue (code given below)
gpur;rpid (FwpaPL)
vote type
Xl;od; tif
Third most
important
Issue K:d;whtJ Kf;fpakhd gpur;rpid
Issue [WRITE EXACTLY]
gpur;rpid ? (brhy ;tij mg ;gona vGJf)
Issue (code given below)
gpur;rpid (FwpaPL)
vote type
Xl;od; tif
Village Qustionnaire – Part B 90
Q.
no Details tptu’;fstptu’;fstptu’;fstptu’;fs; ; ; ;
Last Gram
sabha
filrp fpuhk rig
Previous
Gram sabha
Ke;ija fpuhk rig
481. Presentation or approval of budget? gl;b$l; rku;g;gzk; bra;ag;gl;ljh my;yJ xg;g[jy; mspf;fg;gl;ljh>
presentation only
rku;g;gzk; kl;Lk; 01 01
budget presented and approved
rku;g;gpf;fg;gl;L xg;g[jy; bgwg;gl;lJ 02 02
budget presented but not approved
gl;b$l; rku;g;gpf;fg;gl;lJ Mdhy; xg;g[jy;;; bgwtpy ;iiy
03 03
budget not presented
gl;b$l; rku;g;gpf;fg;gltpy;iy 04 04
482.
Approval of beneficiaries on the agenda?
m$d;lhtpy; ,lk; bgw;wpUe;j gadhsp fSf;F xg;g[jy; jug;gl;ljh>
yes, passed unchanged
khw;wkpy;yhky; xg;g[jy; bra;ag;gl;lJ 01 01
yes, passed after changes
Mk;. khw;w’;fSf;Fg; gpd;du; xg;g[jy; bra;ag;gl;lJ
02 02
yes, but not approved
Mk; . Mdhy; xg;g[jy; jug;gltpy;iy 03 03
no
,y;iy 04 04
483. Are the minutes publicly available?
[right now]
Tl;lj;jpd; epfH;r;rpf; Fwpg;ngLfs; bghJkf;fs; ghh;itf;F fpilf;fpwjh> (,g;nghJ Tl)
Yes Mk; 01 01
No ,y;iy
02 02
Gram Sabha – issues discussed code fpuhk rig ? fye;jhnyhrpj;j gpur;rpidfspd; FwpaPL
Options Codes
Road rhiy 01
Transport nghf;Ftuj;J 02
Health cly; eyk; 03
Education fy;tp 04
Irrigation water ghrdj;jpw;fhd jz;zPh 05
Drinking water Fo jz;zPu; 06
Other agriculture related tptrhak; bjhlu;ghd kw;w gpur;rpidfs; 07
Ceremonies / Festivals g{i$fs;-tpHhf;fs; 08
Disputes tpthj’;fs; 09
Sewage / Sanitation rhf;fil-Rfhjhuk; 10
Construction other than roads or irrigation rhiy kw;Wk; ghrdk; my;yhj fl;Lkhd gzp 11
Access to and use of lands of the panchayat g";rhaj;J epy';fis gad;gLj;JtJ gw;wp 12
Unemployment schemes ntiy ,y;yhjth;fSf;fhd jpl;l’;fs; 13
Civil Supplies (ration shops) Foikg; bghUl;fs; tH’;Fjy; (nu&d; filfs;)
14
Availability of credit fpilf;Fk; fld;fisg; gw;wp 15
Usage of common property bghJ brhj;ij cgnahfpg;gJ Fwpj;J 16
Street light bjUtpsf;F 17
Electricity supply kpd;rhu tpepnahfk; 18
Cremation ground RLfhL 19
Other (specify) kw;wit (Fwpg;gpLf) 20
Village Qustionnaire – Part B 91
Location and characteristics of schools within village or within walking distance of village fpuhkj;jpy;; cs;s my;yJ fpuhkj;jpypUe;J eilJ}uj;jpy; cs;s gs;spf;Tl’;fs; mike;Js;s ,lk; kw;Wk; gz;g[fs; RECORD AS SEPARATE SCHOOL, IF 2 DIFFERENT SYLLABI FOLLOWED IN A SINGLE SCHOOL (LIKE MATRICULATION & CBSE SYLLABUS) xnu gs;spapy; ,uz;L ntW ghl jpl;l’;fs; elj;jpdhy; jdpj;jdp gs;spahf gjpt[ bra;at[k; Fwpg;gplt[k; (bkl;upf;Fny&d;. rpgpv!;, ghlKiw)
SC
HO
OL
FA
CIL
TY
ID
gs;spapd; milahs vz;
NAME OF THE
SCHOOL
gs;spf;Tlj;jpd; gs;spf;Tlj;jpd; gs;spf;Tlj;jpd; gs;spf;Tlj;jpd; bgau;bgau;bgau;bgau;
GPS READING OF
SCHOOLS gs;spf;Tl’;fspd; $pgpv!; uPo’;
If outside
village:
give
distance
from
village
(km.) fpuhkj;jpw;F btspna vdpy;
fpuhkj;jpy; ,Ue;J vt;tst[ J}uk; (fpkP)
What
type of
school is
this?
,J ve;j tifahd gs;sp>
CODE FwpaPL
What was / is
the
educational
system
followed?
gpd;gw;wg;gLk; fy;tp Kiw[ vd;dthf ,Ue;jJ - cs;sJ> CODE FwpaPL
School
management
gs;sp nkyhd;ik
CODE FwpaPL
Year
established
YYYY
Jtf;fg;gl;l tUlk;
Primary Language of
instruction ( Spoken
language for teaching)
(Codes given
below)
fw;gpf;Fk; Kjd;ikahd bkhHp (ngRk; bkhHpapy; fw;gpj;jy;)
(FwpaPLfs; fPnH bfhLf;fg;gl;Ls;sd)
Language of
textbooks
(Codes give
below)
ghlg;
g[j;jf’;fspd; bkhHp (FwpaPLfs;
fPnH bfhLf;fg;gl;Ls;sd)
Do students
learn a
second
language
khztu;fs; ,uz;lhtJ bkhHp gapy; fpd;whuh>
Second Language Taught
fw;gpf;fg;gLk; ,uz;lhtJ bkhHp
What is the
second language
studied?
(Codes give
below)
,uz;lhtjhf vd;d bkhHp
fw;gpf;fg;gLfpwJ> (fPnH
Fwpg;gplt[k;)
What is the
time spent
studying that
language per
week? [IN
HOURS, TO
NEAREST
QUARTER
HOUR. thuj;jpw;F vj;jid kzp neuk; ,uz;lhtJ bkhHpia fw;gjw;F brytplg; gLfpwJ> (kzpapy;) Y
es M
k;
,y;iy →
→
→
→
49
6
Q.no 484. 485. 486. 487. 488. 489. 490. 491. 492. 493. 494. 495.
S1 N: 01 02
E:
S2 N: 01 02
E:
S3 N: 01 02
E:
S4 N: 01 02
E:
S5 N: 01 02
E:
S6 N: 01 02
E:
Village Qustionnaire – Part B 92
Type of School Code
Options Code
Pre – school Muk;gg; gs;sp 01
Primary School
only bjhlf;fg; gs;sp kl;Lk; 02
Primary with
Upper Primary
School
bjhlf;fg; gs;spa[k; eLepiyg; gs;spa[k; 03
Primary with
Upper primary
school and
secondary/higher
secondary school
bjhlf;fg; gs;sp.; eLepiyg; gs;sp. cau;; epiyg; gs;sp kw;Wk; nky; epiyg; gs;sp ,ize;jJ
04
Upper primary
school only eLepiyg; gs;sp kl;Lk; 05
Upper primary
school with
secondary/higher
secondary school
eL epiyg; gs;sp. cau; epiyg; gs;sp kw;Wk; nky; epiyg; gs;sp ,ize;jJ
06
Secondary/
Higher Secondary
school only
cau; epiyg; gs;sp - nky; epiyg; gs;sp kl;Lk;
07
College fy;Y}hp 08
Industrial
Training bjhHpw; gapw;rp
09
Vocational
Training ifj;bjhHpw; gapw;rp
10
Others (Specify) kw;wit (Fwpg;gplt[k; 11
Education – standard Code
Options Code
Pre KG ghy;tho 01
Kindergarten (LKG/ UKG)
kHiyau; gs;sp 02
1st standard 1Mk; tFg;g[ 03
2nd
standard 2Mk; tFg;g[ 04
3rd
standard 3Mk; tFg;g[ 05
4th
standard 4Mk; tFg;g[ 06
5th
standard 5Mk; tFg;g[ 07
6th
standard 6Mk; tFg;g[ 08
7th
standard 7Mk; tFg;g[ 09
8th
standard 8Mk; tFg;g[ 10
9th
standard 9Mk; tFg;g[ 11
10th
standard / SSLC
10Mk; tFg;g[ - v!;v!;vy;rp 12
11th
standard / Junior college
11Mk; tFg;g[- $Pdpau; fhny$; 13
12th
std /HSC/ Junior college
12Mk; tFg;g[-v!;v!;vy;rp-$Pdpau; fhny$;
14
School management type Code
Options Code
Department of education
fy;tpj; Jiw 01
Tribal/social welfare dept
gH’;Foapdu; - rK:f eythH;j;Jiw 02
Local body school
cs;S:u; epu;thf gs;sp 03
Private aided
muR cjtp bgWk; jdpahu; gs;sp 04
Private unaided school
muR cjtp bgwhj jdpahh;gs;sp 05
Other recognized school
kw;w m’;fPfupf;fg;gl;l gs;spfs; 06
Unrecognized schools – religious
m’;fPfupf;fg;glhj gs;spfs; ? kjk; rhu;e;jit
07
Other Unrecognized schools
kw;w m’;fPfupf;fhj gs;spfs; 08
Others kw;wit 09
Language code
Options Code
Tamil jkpH; 01
English M’;fpyk; 02
Hindi ,e;jp 03
Telugu bjY’;F 04
Kannada fd;dlk; 05
Malayalam kiyahsk; 06
Urdu cUJ 07
Others (specify)
____________
kw;wit (Fwpg;gplt[k;) 08
Education system codes
Code
State board
khepyf; fy;tp thupak; 01
Matriculation
bkl;upFny&d; 02
Central board (CBSE)
kj;jpaf; fy;tp thupak; (rpgpv!;<)
03
Anglo Indian (AISC)
M';fpnyh ,e;jpad; 04
Others (Specify)
_______________
kw;wit (Fwpg;gplt[k;) 05
Village Qustionnaire – Part B 93
Schools: basic info cont. gs;spf;Tl’;fs; ? mog;gilj; jfty;fs; ? bjhlh;r;rpgs;spf;Tl’;fs; ? mog;gilj; jfty;fs; ? bjhlh;r;rpgs;spf;Tl’;fs; ? mog;gilj; jfty;fs; ? bjhlh;r;rpgs;spf;Tl’;fs; ? mog;gilj; jfty;fs; ? bjhlh;r;rp S
CH
OO
L F
AC
ILT
Y ID
gs;spf;Tl trjp milahs vz;
Length of typical
school day (exclude
extra classes,
extracurriculars, etc.)
rhjhuz ehspy; gs;spf;Tlj;jpd; ntiy
neuk; (rpwg;g[ tFg;g[f;fis nru;f;f ntz;lhk;)
Specify no. of Hours
kzp neu’;fspd; vz;zpf;if
Time Check
In the past 30 days
the school was
supposed to be
open, how many
days was it open?
fle;j 30 ehl;fspy; gs;sp
jpwe;jpUf;fg;gl ntz;oa ehl;fspy; vj;jid ehl;fs; gs;spf;Tlk; jpwe;jpUe;jJ>
Are school uniforms
required?
gs;spf;Tlj;jpw;F rPUil mky;
bra;ag;gl;Ls;sjh>
Do any students
not possess
textbooks used
for ONE or
MORE of their
classes?
khztu;fs; ahuhtJ ghlg; g[j;jf’;fs;
,y;yhky; xd;W my;yJ mjw;F nkw;gl;l
tFg;g[fSf;F tUfpwhu;fsh>
If yes, what percent of
students do not have
access to needed
textbooks?
Mk; vdpy; vj;jid rjtPj khztu;fs; njitahd
ghlg;g[j;jf’;fs; itj;jpUg;gjpy;iy>
From what source(s) do most students in this school obtain textbooks?
,e;j gs;spf;Tlj;jpYs;;s bgUk;ghyhd khztu;fs; v’;fpUe;J g[j;jf’;fs; th’;Ffpwhu;fs;>
borrow from school gs;spf;Tlj;jpy; ,uty; 01
given free of charge from school
gs;spf;Tlj;jpy; fl;lzkpd;wp ,ytrkhf jug;gLfpwJ
02
purchased from school
gs;spf;Tlj;jpy; th’;fg;gLfpwJ 03
purchased from other source
gpw ,l’;fspy; th’;fg;gLfpwJ 04
photocopy
efy; vLf;fg;gLfpwJ 05
used sibling's or other already owned
rnfhju rnfhjupfs; my;yJ Vw;fdnt brhe;jkhf itj;jpUe;jth;fsplkpUe;J
06
7 = other (Specify)
kw;wit Fwpg;gplt[k;) 07
Time
begun
Jt’;Fk; neuk;
Time
ended
Koa[k; neuk;
AM
fhiy PM
khiy Yes Mk;
No ,y;iy
Yes Mk;
No ,y;iy ���� 503
Source 1
(most common)
Mjhuk; 1 (kpft[k; bghJthd)
Source 2
Mjhuk; 2 Source 3
Mjhuk; 3
Q.no 496. 497. 498. 499. 500. 501. 502. 503.
S1 01 02 01 02
S2 01 02 01 02
S3 01 02 01 02
S4 01 02 01 02
S5 01 02 01 02
S6 01 02 01 02
Village Qustionnaire – Part B 94
List all fees that students are required to pay (e. g. school fee, term fee, admission fee, ID card fee) khztu;fs; fl;l ntz;oa vy;yh fl;lz’;fisa[k; gl;oayplt[k;/ (ck;/ gs;spf;Tl fl;lzk; fhykhztu;fs; fl;l ntz;oa vy;yh fl;lz’;fisa[k; gl;oayplt[k;/ (ck;/ gs;spf;Tl fl;lzk; fhykhztu;fs; fl;l ntz;oa vy;yh fl;lz’;fisa[k; gl;oayplt[k;/ (ck;/ gs;spf;Tl fl;lzk; fhykhztu;fs; fl;l ntz;oa vy;yh fl;lz’;fisa[k; gl;oayplt[k;/ (ck;/ gs;spf;Tl fl;lzk; fhytiuf;fhdtiuf;fhdtiuf;fhdtiuf;fhd fl;lzk;. mDkjpf; flfl;lzk;. mDkjpf; flfl;lzk;. mDkjpf; flfl;lzk;. mDkjpf; fl;lzk;. milahs ml;il fl;lzk; );lzk;. milahs ml;il fl;lzk; );lzk;. milahs ml;il fl;lzk; );lzk;. milahs ml;il fl;lzk; ) SCHOOL – 1 NAME____ ___ FACILITY ID:
gs;sp ? 1 bgau; gs;spf;Tl trjp milahs vz; : Classes
tFg;g[f;fs;
Tution Fees
fy;tp fl;lz’;fs; Uniforms
rPUilfs; Books & Stationary
g[j;jf’;fs; kw;Wk; vGJ bghUl;fs; Other Small Fees
kw;w rpW fl;lz’;fs;
Others (Specify)
kw;wit (Fwpg;gplt[k;)
Others (Specify)
kw;wit (Fwpg;gplt[k;)
amoun
t
(Rs.)
bjhif (U:)
NOTE : IF “0”
→→→→
506 Fwpg;g[ ?;
“0” vdpy;;
→→→→
506
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
NOTE : IF “0”
→→→→508 Fwpg;g[ :
“0” vdpy;
→→→→508508508508
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
NOTE : IF “0”
→ → → → 510
Fwpg;g[ : “0” vdpy;
→ → → → 510
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
NOTE : IF “0”
→ → → → 512
Fwpg;g[ : “0” vdpy;
→ → → → 512
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
NOTE : IF “0”
→ → → → 514 Fwpg;g[ :
“0” vdpy;
→ → → → 514
how often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:) NOTE : IF “0” SKIP TO NEXT
STD Fwpg;g[ :
“0” vdpy; mLj;j tFg;gpw;F bry;yt[k;
how often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ> Numbe
r of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3 thuk;?1 khjk;?2 tUlk;?3
Number of
times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of
times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year - 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Q.no 504. 505. 506. 507. 508. 509. 510. 511. 512. 513. 514. 515.
1st Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
2nd
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
3rd
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
4th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
5th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
6th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
7th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
8th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
9th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
10th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
Village Qustionnaire – Part B 95
SCHOOL – 2 NAME____ ___ FACILITY ID:
gs;sp ? 2 bgau; gs;spf;Tl trjp milahs vz; :
Classes
tFg;g[f;fs;
Tution Fees
fy;tp fl;lz’;fs; Uniforms
rPUilfs; Books & Stationary
g[j;jf’;fs; kw;Wk; vGJ bghUl;fs; Other Small Fees
kw;w rpW fl;lz’;fs;
Others (Specify)
kw;wit (Fwpg;gplt[k;)
Others (Specify)
kw;wit (Fwpg;gplt[k;)
amount
(Rs.)
bjhif (U:)
if 00
����518
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
if 00
����555520202020
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:) ;
if 00
����522
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
if 00
����555524242424
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
if 00
����555526262626
how often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:) NOTE : IF “0” SKIP TO NEXT
STD Fwpg;g[ :
“0” vdpy; mLj;j tFg;gpw;F bry;yt[k;
how often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ> Numbe
r of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3 thuk;?1 khjk;?2 tUlk;?3
Number of
times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of
times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year - 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Q.no 516. 517. 518. 519. 520. 521. 522. 523. 524. 525. 526. 527.
1st Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
2nd
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
3rd
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
4th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
5th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
6th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
7th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
8th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
9th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
10th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
Village Qustionnaire – Part B 96
SCHOOL – 3 NAME____ ___ FACILITY ID:
gs;sp ? 3 bgau; gs;spf;Tl trjp milahs vz; : Classes
tFg;g[f;fs;
Tution Fees
fy;tp fl;lz’;fs; Uniforms
rPUilfs; Books & Stationary
g[j;jf’;fs; kw;Wk; vGJ bghUl;fs; Other Small Fees
kw;w rpW fl;lz’;fs;
Others (Specify)
kw;wit (Fwpg;gplt[k;)
Others (Specify)
kw;wit (Fwpg;gplt[k;)
amount
(Rs.)
bjhif (U:)
if 00
����530
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
if 00
����555533332222
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:) ;
if 00
����534
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
if 00
����555533336666
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
if 00
����555533338888
how often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:) NOTE : IF “0” SKIP TO NEXT
STD Fwpg;g[ :
“0” vdpy; mLj;j tFg;gpw;F bry;yt[k;
how often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ> Numbe
r of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3 thuk;?1 khjk;?2 tUlk;?3
Number of
times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of
times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year - 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Q.no 528. 529. 530. 531. 532. 533. 534. 535. 536. 537. 538. 539.
1st Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
2nd
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
3rd
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
4th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
5th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
6th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
7th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
8th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
9th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
10th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
Village Qustionnaire – Part B 97
SCHOOL – 4 NAME____ ___ FACILITY ID:
gs;sp ? 4 bgau; gs;spf;Tl trjp milahs vz; :
Classes
tFg;g[f;fs;
Tution Fees
fy;tp fl;lz’;fs; Uniforms
rPUilfs; Books & Stationary
g[j;jf’;fs; kw;Wk; vGJ bghUl;fs; Other Small Fees
kw;w rpW fl;lz’;fs;
Others (Specify)
kw;wit (Fwpg;gplt[k;)
Others (Specify)
kw;wit (Fwpg;gplt[k;)
amount
(Rs.)
bjhif (U:)
if 00
����542
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
if 00
����555544444444
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:) ;
if 00
����546
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
if 00
����555548484848
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
if 00
����555550505050
how often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:) NOTE : IF “0” SKIP TO NEXT
STD Fwpg;g[ :
“0” vdpy; mLj;j tFg;gpw;F bry;yt[k;
how often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ> Numbe
r of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3 thuk;?1 khjk;?2 tUlk;?3
Number of
times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of
times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year - 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Q.no 540. 541. 542. 543. 544. 545. 546. 547. 548. 549. 550. 551.
1st Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
2nd
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
3rd
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
4th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
5th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
6th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
7th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
8th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
9th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
10th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
Village Qustionnaire – Part B 98
SCHOOL – 5 NAME____ ___ FACILITY ID:
gs;sp ? 5 bgau; gs;spf;Tl trjp milahs vz; : Classes
tFg;g[f;fs;
Tution Fees
fy;tp fl;lz’;fs; Uniforms
rPUilfs; Books & Stationary
g[j;jf’;fs; kw;Wk; vGJ bghUl;fs; Other Small Fees
kw;w rpW fl;lz’;fs;
Others (Specify)
kw;wit (Fwpg;gplt[k;)
Others (Specify)
kw;wit (Fwpg;gplt[k;)
amount
(Rs.)
bjhif (U:)
if 00
����554
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
if 00
����555556565656
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:) ;
if 00
����558
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
if 00
����555560606060
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
if 00
����555562626262
how often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:) NOTE : IF “0” SKIP TO NEXT
STD Fwpg;g[ :
“0” vdpy; mLj;j tFg;gpw;F bry;yt[k;
how often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ> Numbe
r of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3 thuk;?1 khjk;?2 tUlk;?3
Number of
times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of
times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year - 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Q.no 552. 553. 554. 555. 556. 557. 558. 559. 560. 561. 562. 563.
1st Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
2nd
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
3rd
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
4th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
5th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
6th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
7th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
8th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
9th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
10th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
Village Qustionnaire – Part B 99
SCHOOL – 6 NAME____ ___ FACILITY ID:
gs;sp ? 6 bgau; gs;spf;Tl trjp milahs vz; :
Classes
tFg;g[f;fs;
Tution Fees
fy;tp fl;lz’;fs; Uniforms
rPUilfs; Books & Stationary
g[j;jf’;fs; kw;Wk; vGJ bghUl;fs; Other Small Fees
kw;w rpW fl;lz’;fs;
Others (Specify)
kw;wit (Fwpg;gplt[k;)
Others (Specify)
kw;wit (Fwpg;gplt[k;)
amount
(Rs.)
bjhif (U:)
If 00
����566
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
If 00
����555568686868
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:) ;
if 00
����570
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
if 00
����555572727272
How often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:)
if 00
����555574747474
how often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ>
amount
(Rs.)
bjhif (U:) NOTE : IF “0” SKIP TO NEXT
STD Fwpg;g[ :
“0” vdpy; mLj;j tFg;gpw;F bry;yt[k;
how often paid?
vt;tst[ mof;fo fl;lg;gL
fpwJ> Numbe
r of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3 thuk;?1 khjk;?2 tUlk;?3
Number of
times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Number of
times vj;jid jlit fs ;
Per week – 1,
Per month – 2,
In a Year - 3
thuk;?1 khjk;?2 tUlk;?3
Number of times vj;jid jlit fs ;;
Per week – 1,
Per month – 2,
In a Year – 3
thuk;?1 khjk;?2 tUlk;?3
Q.no 564. 565. 566. 567. 568. 569. 570. 571. 572. 573. 574. 575.
1st Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
2nd
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
3rd
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
4th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
5th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
6th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
7th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
8th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
9th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
10th
Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03
Village Qustionnaire – Part B 100
Schools: Enrollment and teacher details
gs;spf;Tl’;fs; ? khztu; nrh;f;if kw;Wk; Mrpupau; gw;wpa tptu’;fs;gs;spf;Tl’;fs; ? khztu; nrh;f;if kw;Wk; Mrpupau; gw;wpa tptu’;fs;gs;spf;Tl’;fs; ? khztu; nrh;f;if kw;Wk; Mrpupau; gw;wpa tptu’;fs;gs;spf;Tl’;fs; ? khztu; nrh;f;if kw;Wk; Mrpupau; gw;wpa tptu’;fs; School
number
gs;spf; Tl vz;
Details of Enrolled Students gs;spapy; nru;e;J gof;Fk; khztu;fspd;;; tptu’;fs;
Number of teachers Mrpupau;fspd; vz;zpf;if Headmaster jiyik Mrpupah;
number of
male
students
(2008 –
2009)
Mz;;Mz;;Mz;;Mz;; khztu;fspd;
vz;zpf;if
(2008 –
2009)
number
of
female
students
(2008 –
2009)
bgz;;;bgz;;;bgz;;;bgz;;; khztpfspd;
vz;zpf;if
(2008 –
2009)
what percent of
enrolled
students are in
school on a
typical day?
(2008 – 2009)
gs;spapy; nru;e;J gof;Fk;
khztu;fspy; vj;jid rjtPjk; ngu; xU ruhrup ehspy; gs;spf;F
tUfpwhu;fs;> (2008 – 2009)
enrollmen
t for
previous
school
year
(2007 –
2008)
Ke;ija Mz;oy; khztu; nru;f;if (2007 –
2008)
Sex ghypdk; Qualification
fy;tpj; jFjp Experience mDgtk; Sex;
Years in
position
gjtpapy; vj;jid tUl’;fs; ,Uf;fpwhu;>
Qualification
fy;tpj; jFjp high school
diploma cau;epiy fy;tp- gl;lag; gog;g[
01
graduate
degree
,sepiy gl;ljhup
02
post-
graduate
degree KJepiy gl;ljhup
03
Name, if
resident of
village
fpuhk thrp vdpy; bgau; vd;d>
HH
ID
FLk;g milahs vz;
Memb
er ID cWg;gpdu; milahs vz;
M
Mz; F
bgz; Undergr
aduate
(high
school
diploma
, etc.)
cau; epiy fy;tp- gl;lag; gog;g[
graduat
e degree
(B.A.,
B.SC.,
B.COM
)
,s epiy gl;ljhupfs;
post-
graduate
degree
(M.A.,
M.SC.,
M.COM)
KJ epiy gl;ljhupfs;
have
taught 2
years or
less
2 tUlk; my;yJ mjw;F Fiwthf gapw;Wtpj; Js;stu;f
s;
have
taught
between 2
and 10
years
2 ?? 10 tUl’;fs; gapw;Wtpj; Js;stu;f
s;
have
taught 10
years or
more
10 ?
tUl’;fSf;F nky; gapw;W tpj;Js;stu;fs;
M
Mz;
F
bgz;
Q.no 576. 577. 578. 579. 580. 581. 582. 583. 584. 585. 586. 587. 588. 589. 590. 591. 592.
S1
01 02
S2
01 02
S3
01 02
S4
01 02
S5
01 02
S6
01 02
Village Qustionnaire – Part B 101
Schools: Facilities and programs gs;spf;Tl’;fs; ? trjpfs; kw;Wk; jpl;l’;fs;gs;spf;Tl’;fs; ? trjpfs; kw;Wk; jpl;l’;fs;gs;spf;Tl’;fs; ? trjpfs; kw;Wk; jpl;l’;fs;gs;spf;Tl’;fs; ? trjpfs; kw;Wk; jpl;l’;fs; SL Source of
drinking
water
CODE
FoePUf; fhd Mjhuk; FwpaPL
Does the
school
have
electricity?
gs;spf; Tlj;jp;y; kpd; trjp ,Uf;fpw jh>
Does your
school have
a library?
c’;fs; gs;spapy; xU E}yfk; cs;sjh>
If yes,
approxi
mately
how
many
books
does it
have? \
Mk; vdpy; . njhuha khf mjpy; vj;jid g[j;jf’;fs; cs;sd>
Does the
school provide
midday meals?
gs;spapy; kjpa czt[ tH’;fg; gLfpwjh> 01 = yes, to all
students
Mk;/ vy;nyhUf;Fk; 02 = yes, only to
some students
Mk;. rpy khztu; fSf;F kl;Lk; 03 = no
,y;iy
Does the
school have a
parents'
committee or
Parent
Teacher’s
Association?
gs;spapy; bgw;nwhu; mikg;g[ my;yJ bgw;nwhh; Mrpupau; fHfk; cs;sjh>
If yes, how
many times
has it met in
the previous
year?
Mk; vdpy;. mJ fle;j tUlj;jpy; vj;jid Kiw To cs;sJ> vz;zpf;if
How many [ . . .] does your school have?
c’;fs; gs;spapy; vj;jid /////// cs;sJ> Does the school have
[ . . .]? 1 = yes; 2 = no
[ . . .]gs;spapy; ,Uf;fpwjh> 1=Mk;. 2=,y;iy
Computers for
students use
khztu;fs; gad; gLj;j fk;g;a{l;lu;fs;
Functional Lavatories
fHpg;giwfs; Black
boards
fUk; gyif fs;
vz;zpf;if
NOs.
No. of
classrooms
for
teaching.
ghlk; elj;Jk; tFg;giwfspd; vz;zpf;if
NOs.
Laboratory
gupnrhjidf; Tlk;
playground /
sports field tpisahl;L ikjhdk
FURNITURE
FOR
TEACHERS
Mrpupau; fSf;fhd ehw;fhyp nkirfs;
connected
to the
internet
,d;lu;; bel; ,izg;g[ld; vj;jid cs;sd>
NOs.
not
connecte
d to the
internet
,d;lu; bel; ,izg;g[ ,y;;yhky; vj;jid cs;sd> NOs.
girls only
khztpfSf;F kl;Lk;
NOs.
Common
toilet
,UghyUf;fhd fHptiw NOs.
Ye
s Mk;
No ,y;iy
Yes Mk;
No ,y;iy
→ → → →
597597597597
Yes Mk;
No ,y;iy
→→→→
600600600600
Yes Mk;
No ,y;iy
Yes Mk;
No ,y;iy
Yes Mk;
No ,y;iy
Q.
no 593. 594. 595. 596. 597. 598. 599. 600. 601. 602. 603. 604. 605. 606. 607. 608.
S1 01 02 01 02
01 02
01 02 01 02 01 02
S2 01 02 01 02
01 02
01 02 01 02 01 02
S3 01 02 01 02
01 02
01 02 01 02 01 02
S4 01 02 01 02
01 02
01 02 01 02 01 02
S5 01 02 01 02
01 02
01 02 01 02 01 02
S6 01 02 01 02
01 02
01 02 01 02 01 02
Village Qustionnaire – Part B 102
Health Services: Visits by Outside Village Health workers Rfhjhu Rfhjhu Rfhjhu Rfhjhu nritfs;nritfs;nritfs;nritfs; ???? btsp fpuhkj;jpypUe;J ghh;itapLk; btsp fpuhkj;jpypUe;J ghh;itapLk; btsp fpuhkj;jpypUe;J ghh;itapLk; btsp fpuhkj;jpypUe;J ghh;itapLk; Rfhjhu Rfhjhu Rfhjhu Rfhjhu gzpahsu;fs;gzpahsu;fs;gzpahsu;fs;gzpahsu;fs;
Type of services
nritfspd; tif
Frequency of visits by (code)*
vt;tst[ fhy ,ilbtspapy; tprpl; bra;ag;gLfpwJ> (FwpaPL) * Do the visitor(s)
conduct this effort at
an existing medical
clinic/facility in the
village?
,e;j Rfhjhu gzpahsu;fs; c’;fs; Chpy; ,g;nghJs;s xU kUj;Jtkid- kUj;Jt trjpa[s;s ,lj;jpy; nrit bra;fpwhu;fsh>
If yes, where have
these efforts
conducted ?
Mk; vdpy;. v’;F ,Ue;J
eltof;if vLf;fg;gLfpwJ>
[write exactly]
Like Name, Type
of facility (e.g.,
anganwadi ,
Clinic, etc)
(rupahf vGjt[k;) bgau;. kUj;Jt nrit tH’;Fk; ,lj;jpd; tif (m’;fd;tho. kUe;jfk; ,ju)
MULTICODING
POSSIBLE
gy gjpy;fs; rhj;jpak;
Health
FACILITY
ID
(Copy
from
Village
Questionna
ire)
Rfhjhu trjpfs; milahs vz;
Doctors from govt. or other govt. officials
murh’;f lhf;lu;fs; my;yJ gpw murh’;f mYtyu;fs;
Doctors from NGO, university, religious
organization
bjhz;L epWtd’;fs;. gy;fiyf; fHf’;fs; kw;Wk; kj mikg;g[fspypUe;J tUk; lhf;lu;fs;
Other visiting medical personel/
paramedics/VHN/CHN tprpl; bra;a[k; gpw kUj;Jt mYtyu;fs;- kUj;Jt fsg;gzpahsu;fs;-tpvr;vd;-rpvr;vd;-gzpahsh;fs;
Number of times
Note: If “On call /
emergency” – write 1
and circle “4”
If “Never” – record “0”
and circle “5” in the
next column.
tprpl; bra;a[k; vz;zpf;iffs; Fwpg;g[ ? Tg;gpl;l neuj;jpy; mtruk; vdpy;. 1 vGjp 4?I tl;lkplt[k; ,y;iybadpy; 0?it gjpt[ bra;J 5?I tl;lkplt[k;
Per week – 1,
Per month – 2,
Per Year – 3
On call /
emergency – 4
Never – 5
thuk;?1 khjk;?2 tUlk;?3 mtruj;jpy;?4 xUbghGJk; ,y;iy?5
Number of times
Note: If “On call /
emergency” – write 1 and
circle “4”
If “Never” – record “0”
and circle “5” in the next
column. tprpl; bra;a[k; vz;zpf;iffs; Fwpg;g[ ? Tg;gpl;l neuj;jpy; mtruk; vdpy;. 1 vGjp 4?I Fwpg;gplt[k; ,y;iybadpy; 0?it gjpt[ bra;J 5?I tl;lkplt[k;
Per week – 1,
Per month – 2,
Per Year – 3
On call /
emergency – 4
Never – 5
thuk;?1 khjk;?2 tUlk;?3 mtruj;jpy;?4 xUbghGJk; ,y;iy?5
Number of times
Note: If “On call /
emergency” – write 1
and circle “4”
If “Never” – record
“0” and circle “5” in
the next column.
tprpl; bra;a[k; vz;zpf;iffs; Fwpg;g[ ? Tg;gpl;l neuj;jpy; mtruk; vdpy;. 1 vGjp 4?I Fwpg;gplt[k; ,y;iybadpy; 0?it gjpt[ bra;J 5?I tl;lkplt[k;
Per week – 1,
Per month – 2,
Per Year – 3
On call /
emergency – 4
Never – 5
thuk;?1 khjk;?2 tUlk;?3 mtruj;jpy;?4 xUbghGJk; ,y;iy?5
Yes Mk;
No ,y;iy ����NEXT
ROW
Q.no 609. 610. 611. 612. 613. 614.
Water
purification
jz;zPu; Rj;jfupg;g[
Chlorinate wells Fnshupd; fyf;fg;gLk; fpzWfs;
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
Malaria
eradication
knyupah xHpg;g[
Spraying
bjspj;jy;
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
Blood slides
,uj;j rhk;gps; !;iyLfs;
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
01
02
→ → → → Next
type
Quinine pills
Fapdh khj;jpiufs;
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
01
02
→ → → → Next
type
Other malaria eradication
efforts (specify):
kw;w knyupah XHpg;g[ Kiwfs;;;; (Fwpg;gpLf)
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
01
02
→ → → → Next
type
Blindness prevention & cure
fz;;; ghu;it ,Hg ;ig jLj ;jy ; kw ;Wk ; Fzg ;gLj ;Jjy ;
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
01
02
→ → → → Next
type
Village Qustionnaire – Part B 103
Type of services
nritfspd; tif
Frequency of visits by (code)*
vt;tst[ fhy ,ilbtspapy; tprpl; bra;ag;gLfpwJ> (FwpaPL) * Do the visitor(s)
conduct this effort at
an existing medical
clinic/facility in the
village?
,e;j Rfhjhu gzpahsu;fs; c’;fs; Chpy; ,g;nghJs;s xU kUj;Jtkid- kUj;Jt trjpa[s;s ,lj;jpy; nrit bra;fpwhu;fsh>
If yes, where have
these efforts
conducted ?
Mk; vdpy;. v’;F ,Ue;J
eltof;if vLf;fg;gLfpwJ>
[write exactly]
Like Name, Type
of facility (e.g.,
anganwadi ,
Clinic, etc)
(rupahf vGjt[k;) bgau;. kUj;Jt nrit tH’;Fk; ,lj;jpd; tif (m’;fd;tho. kUe;jfk; ,ju)
MULTICODING
POSSIBLE
gy gjpy;fs; rhj;jpak;
Health
FACILITY
ID
(Copy
from
Village
Questionna
ire)
Rfhjhu trjpfs; milahs vz;
Doctors from govt. or other govt. officials
murh’;f lhf;lu;fs; my;yJ gpw murh’;f mYtyu;fs;
Doctors from NGO, university, religious
organization
bjhz;L epWtd’;fs;. gy;fiyf; fHf’;fs; kw;Wk; kj mikg;g[fspypUe;J tUk; lhf;lu;fs;
Other visiting medical personel/
paramedics/VHN/CHN tprpl; bra;a[k; gpw kUj;Jt mYtyu;fs;- kUj;Jt fsg;gzpahsu;fs;-tpvr;vd;-rpvr;vd;-gzpahsh;fs;
Number of times
Note: If “On call /
emergency” – write 1
and circle “4”
If “Never” – record “0”
and circle “5” in the
next column.
tprpl; bra;a[k; vz;zpf;iffs; Fwpg;g[ ? Tg;gpl;l neuj;jpy; mtruk; vdpy;. 1 vGjp 4?I tl;lkplt[k; ,y;iybadpy; 0?it gjpt[ bra;J 5?I tl;lkplt[k;
Per week – 1,
Per month – 2,
Per Year – 3
On call /
emergency – 4
Never – 5
thuk;?1 khjk;?2 tUlk;?3 mtruj;jpy;?4 xUbghGJk; ,y;iy?5
Number of times
Note: If “On call /
emergency” – write 1 and
circle “4”
If “Never” – record “0”
and circle “5” in the next
column. tprpl; bra;a[k; vz;zpf;iffs; Fwpg;g[ ? Tg;gpl;l neuj;jpy; mtruk; vdpy;. 1 vGjp 4?I Fwpg;gplt[k; ,y;iybadpy; 0?it gjpt[ bra;J 5?I tl;lkplt[k;
Per week – 1,
Per month – 2,
Per Year – 3
On call /
emergency – 4
Never – 5
thuk;?1 khjk;?2 tUlk;?3 mtruj;jpy;?4 xUbghGJk; ,y;iy?5
Number of times
Note: If “On call /
emergency” – write 1
and circle “4”
If “Never” – record
“0” and circle “5” in
the next column.
tprpl; bra;a[k; vz;zpf;iffs; Fwpg;g[ ? Tg;gpl;l neuj;jpy; mtruk; vdpy;. 1 vGjp 4?I Fwpg;gplt[k; ,y;iybadpy; 0?it gjpt[ bra;J 5?I tl;lkplt[k;
Per week – 1,
Per month – 2,
Per Year – 3
On call /
emergency – 4
Never – 5
thuk;?1 khjk;?2 tUlk;?3 mtruj;jpy;?4 xUbghGJk; ,y;iy?5
Yes Mk;
No ,y;iy ����NEXT
ROW
Q.no 609. 610. 611. 612. 613. 614.
Immunization of children
FHe;ijfSf;F jLg;g{rp
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
01
02
→ → → → Next
type
Help for
pregnant
women
fh;gpzpg; bgz;fSf;fhd cjtpfs;
Iron & Vitamin pills
,Uk;g[r; rj;J & tpl;lkpd; khj;jpiufs;
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5 01
02
→ → → → Next
type
Prenatal check-ups
gpurtj;jpw;F Ke;ija gupnrhjidfs;
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5 01
02
→ → → → Next
type
Deliver babies
gpurtk; ghu;j;jy;
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5 01
02
→ → → → Next
type
Other help for pregnant
women (specify):
fUt[w;w bgz;fSf;F kw;w cjtpfs; (Fwpg;gpLf)
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5 01
02
→ → → → Next
type
Village Qustionnaire – Part B 104
Type of services
nritfspd; tif
Frequency of visits by (code)*
vt;tst[ fhy ,ilbtspapy; tprpl; bra;ag;gLfpwJ> (FwpaPL) * Do the visitor(s)
conduct this effort at
an existing medical
clinic/facility in the
village?
,e;j Rfhjhu gzpahsu;fs; c’;fs; Chpy; ,g;nghJs;s xU kUj;Jtkid- kUj;Jt trjpa[s;s ,lj;jpy; nrit bra;fpwhu;fsh>
If yes, where have
these efforts
conducted ?
Mk; vdpy;. v’;F ,Ue;J
eltof;if vLf;fg;gLfpwJ>
[write exactly]
Like Name, Type
of facility (e.g.,
anganwadi ,
Clinic, etc)
(rupahf vGjt[k;) bgau;. kUj;Jt nrit tH’;Fk; ,lj;jpd; tif (m’;fd;tho. kUe;jfk; ,ju)
MULTICODING
POSSIBLE
gy gjpy;fs; rhj;jpak;
Health
FACILITY
ID
(Copy
from
Village
Questionna
ire)
Rfhjhu trjpfs; milahs vz;
Doctors from govt. or other govt. officials
murh’;f lhf;lu;fs; my;yJ gpw murh’;f mYtyu;fs;
Doctors from NGO, university, religious
organization
bjhz;L epWtd’;fs;. gy;fiyf; fHf’;fs; kw;Wk; kj mikg;g[fspypUe;J tUk; lhf;lu;fs;
Other visiting medical personel/
paramedics/VHN/CHN tprpl; bra;a[k; gpw kUj;Jt mYtyu;fs;- kUj;Jt fsg;gzpahsu;fs;-tpvr;vd;-rpvr;vd;-gzpahsh;fs;
Number of times
Note: If “On call /
emergency” – write 1
and circle “4”
If “Never” – record “0”
and circle “5” in the
next column.
tprpl; bra;a[k; vz;zpf;iffs; Fwpg;g[ ? Tg;gpl;l neuj;jpy; mtruk; vdpy;. 1 vGjp 4?I tl;lkplt[k; ,y;iybadpy; 0?it gjpt[ bra;J 5?I tl;lkplt[k;
Per week – 1,
Per month – 2,
Per Year – 3
On call /
emergency – 4
Never – 5
thuk;?1 khjk;?2 tUlk;?3 mtruj;jpy;?4 xUbghGJk; ,y;iy?5
Number of times
Note: If “On call /
emergency” – write 1 and
circle “4”
If “Never” – record “0”
and circle “5” in the next
column. tprpl; bra;a[k; vz;zpf;iffs; Fwpg;g[ ? Tg;gpl;l neuj;jpy; mtruk; vdpy;. 1 vGjp 4?I Fwpg;gplt[k; ,y;iybadpy; 0?it gjpt[ bra;J 5?I tl;lkplt[k;
Per week – 1,
Per month – 2,
Per Year – 3
On call /
emergency – 4
Never – 5
thuk;?1 khjk;?2 tUlk;?3 mtruj;jpy;?4 xUbghGJk; ,y;iy?5
Number of times
Note: If “On call /
emergency” – write 1
and circle “4”
If “Never” – record
“0” and circle “5” in
the next column.
tprpl; bra;a[k; vz;zpf;iffs; Fwpg;g[ ? Tg;gpl;l neuj;jpy; mtruk; vdpy;. 1 vGjp 4?I Fwpg;gplt[k; ,y;iybadpy; 0?it gjpt[ bra;J 5?I tl;lkplt[k;
Per week – 1,
Per month – 2,
Per Year – 3
On call /
emergency – 4
Never – 5
thuk;?1 khjk;?2 tUlk;?3 mtruj;jpy;?4 xUbghGJk; ,y;iy?5
Yes Mk;
No ,y;iy ����NEXT
ROW
Q.no 609. 610. 611. 612. 613. 614.
Nutritional
supplements
Cl;lr;rj;J <L bra;a[k;; bghUl;fs;
For breast-feeding
women
ghY}l;Lk; jha; khu;fSf;F
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5 01
02
→ → → → Next
type
For children
FHe;ijfSf;F
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5 01
02
→ → → → Next
type
For everyone
vy;nyhUf;Fk;
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5 01
02
→ → → → Next
type
General health education / advice bghJ Mnuhf;fpa fy;tp-mwpt[iu
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5 01
02
→ → → → Next
type
Family planning education FLk;gf; fl;Lg;ghl;Lf; fy;tp
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5 01
02
→ → → → Next
type
Condom distribution
Mqiw tpdpnahfk;
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5 01 02
→ → → → Next
Village Qustionnaire – Part B 105
Type of services
nritfspd; tif
Frequency of visits by (code)*
vt;tst[ fhy ,ilbtspapy; tprpl; bra;ag;gLfpwJ> (FwpaPL) * Do the visitor(s)
conduct this effort at
an existing medical
clinic/facility in the
village?
,e;j Rfhjhu gzpahsu;fs; c’;fs; Chpy; ,g;nghJs;s xU kUj;Jtkid- kUj;Jt trjpa[s;s ,lj;jpy; nrit bra;fpwhu;fsh>
If yes, where have
these efforts
conducted ?
Mk; vdpy;. v’;F ,Ue;J
eltof;if vLf;fg;gLfpwJ>
[write exactly]
Like Name, Type
of facility (e.g.,
anganwadi ,
Clinic, etc)
(rupahf vGjt[k;) bgau;. kUj;Jt nrit tH’;Fk; ,lj;jpd; tif (m’;fd;tho. kUe;jfk; ,ju)
MULTICODING
POSSIBLE
gy gjpy;fs; rhj;jpak;
Health
FACILITY
ID
(Copy
from
Village
Questionna
ire)
Rfhjhu trjpfs; milahs vz;
Doctors from govt. or other govt. officials
murh’;f lhf;lu;fs; my;yJ gpw murh’;f mYtyu;fs;
Doctors from NGO, university, religious
organization
bjhz;L epWtd’;fs;. gy;fiyf; fHf’;fs; kw;Wk; kj mikg;g[fspypUe;J tUk; lhf;lu;fs;
Other visiting medical personel/
paramedics/VHN/CHN tprpl; bra;a[k; gpw kUj;Jt mYtyu;fs;- kUj;Jt fsg;gzpahsu;fs;-tpvr;vd;-rpvr;vd;-gzpahsh;fs;
Number of times
Note: If “On call /
emergency” – write 1
and circle “4”
If “Never” – record “0”
and circle “5” in the
next column.
tprpl; bra;a[k; vz;zpf;iffs; Fwpg;g[ ? Tg;gpl;l neuj;jpy; mtruk; vdpy;. 1 vGjp 4?I tl;lkplt[k; ,y;iybadpy; 0?it gjpt[ bra;J 5?I tl;lkplt[k;
Per week – 1,
Per month – 2,
Per Year – 3
On call /
emergency – 4
Never – 5
thuk;?1 khjk;?2 tUlk;?3 mtruj;jpy;?4 xUbghGJk; ,y;iy?5
Number of times
Note: If “On call /
emergency” – write 1 and
circle “4”
If “Never” – record “0”
and circle “5” in the next
column. tprpl; bra;a[k; vz;zpf;iffs; Fwpg;g[ ? Tg;gpl;l neuj;jpy; mtruk; vdpy;. 1 vGjp 4?I Fwpg;gplt[k; ,y;iybadpy; 0?it gjpt[ bra;J 5?I tl;lkplt[k;
Per week – 1,
Per month – 2,
Per Year – 3
On call /
emergency – 4
Never – 5
thuk;?1 khjk;?2 tUlk;?3 mtruj;jpy;?4 xUbghGJk; ,y;iy?5
Number of times
Note: If “On call /
emergency” – write 1
and circle “4”
If “Never” – record
“0” and circle “5” in
the next column.
tprpl; bra;a[k; vz;zpf;iffs; Fwpg;g[ ? Tg;gpl;l neuj;jpy; mtruk; vdpy;. 1 vGjp 4?I Fwpg;gplt[k; ,y;iybadpy; 0?it gjpt[ bra;J 5?I tl;lkplt[k;
Per week – 1,
Per month – 2,
Per Year – 3
On call /
emergency – 4
Never – 5
thuk;?1 khjk;?2 tUlk;?3 mtruj;jpy;?4 xUbghGJk; ,y;iy?5
Yes Mk;
No ,y;iy ����NEXT
ROW
Q.no 609. 610. 611. 612. 613. 614.
type Other (specify):
kw;wit (Fwpg;gpLf)
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5 01
02
→ → → → Next
type
Other (specify):
kw;wit (Fwpg;gpLf)
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5 01 02
→ 6→ 6→ 6→ 611115555
Village Qustionnaire – Part B 106
Types of health workers currently available in this village: ,e;j ,e;j ,e;j ,e;j fpuhkj;jpy; fpuhkj;jpy; fpuhkj;jpy; fpuhkj;jpy; jw;rkak; jw;rkak; jw;rkak; jw;rkak; fpilf;Fk; fpilf;Fk; fpilf;Fk; fpilf;Fk; Rfhjhu Rfhjhu Rfhjhu Rfhjhu gzpahsu;fsgzpahsu;fsgzpahsu;fsgzpahsu;fspd; tifpd; tifpd; tifpd; tif
Q. no Options code
615. Is there Trained dai available in this Village?
gapw;rp bgww jha; ,e;j fpuhkj;jpy; cs;shuh> Yes Mk; 01
No ,y;iy 02
616. Is there Trained male health worker available in this Village?
gapw;rp bgw;w Mz; Rfhjhu gzpahsu; ,e;j fpuhkj;jpy; cs;shuh> Yes Mk; 01
No ,y;iy 02
617. Is there Trained female health worker available in this Village?
gapw;rp bgw;w bgz; Rfhjhu gzpahsu; ,e;j fpuhkj;jpy; cs;shuh> Yes Mk; 01
No ,y;iy 02
NEAREST HEALTH CARE PROVIDERS OUTSIDE THE VILLAGE fpuhkj;jpw;F btspfpuhkj;jpw;F btspfpuhkj;jpw;F btspfpuhkj;jpw;F btspapy; mUfhikapapy; mUfhikapapy; mUfhikapapy; mUfhikapYs;s Rfhjhu guhkupg;g[ nriYs;s Rfhjhu guhkupg;g[ nriYs;s Rfhjhu guhkupg;g[ nriYs;s Rfhjhu guhkupg;g[ nrit t t t ika’;fs;ika’;fs;ika’;fs;ika’;fs; SNO INVESTIGATOR: REFER TO
FIRST PAGE OF VILLAGE
SCHEDULE AS CROSS CHECK
ngl;o vLg;gth; /; fpuhk ml;ltizapd; Kjy; gf;fj;ijg; rhpghh;g;gjw;F itj;Jf; bfhs;st[k;
Is there a [….] in
this village? IF
NO � NEXT
ROW
fpuhkj;jpy; xU
[….] cs;sjh> ,y;iy vdpy; mLj;j tupirf;Fr; bry;yt[k;
Year of
establishment
Jtf;fg;gl;l tUlk;
Number of patients
treated/ day
xU ehisf;F rpfpr;ir bgWk; nehahspfspd; vz;zpf;if
Open how many
days in a week?
xU thuj;jpy; vj;jid ehs; jpwe;jpUf;Fk;>
No. of hrs. per
day
xU ehisf;F vj;jid kzp neuk; jpwe;jpUf;Fk; >
Male doctors in place
Mz; kUj;Jth; ,Uf;fpwhuh> ,Ue;jhy; vj;jid Mz; kUj;Jtu;fs;>
Female Doctors in Place
bgz; kUj;Jth; ,Uf;fpwhuh> ,Ue;jhy; vj;jid bgz; kUj;Jtu;fs;>
Number of beds
available for
treatment and
delivery rpfpr;ir mspg;gjw;Fk; gpurtk; ghu;g;gjw;Fk; fpilf;Fk; bkhj;j gLf;iffspd; vz;zpf;if
Yes Mk;
No ,y;iy
Yes Mk;
No ,y;iy →→→→ 6 6 6 625252525
Number
vz;zpf;if Yes Mk;
No ,y;iy −−>6−−>6−−>6−−>627272727
Number
vz;zpf;if
Q.no 618. 619. 620. 621. 622. 623. 624. 625. 626. 627.
1 Government / Municipal Hospital
murh’;f - Kdprpgy; kUj;Jtkid 01 02
01 02
01 02
2 Govrnment Dispensary
muR kUe;jfk; 01 02
01 02
01 02
3 UHC / UHP / UFWC
a[b\r;rp - a[b\r;gp- a[v`;g;lgps;a[ rp
01 02
01 02
01 02
4 Community Health Centre (CHC) /
Rural Hospital / PHC
rKjha Rfhjhu ikak; (CHC) - fpuhk kUj;Jtkid / Muk;g Rfhjhu epiyak;-PHC
01 02
01 02
01 02
Village Qustionnaire – Part B 107
SNO INVESTIGATOR: REFER TO
FIRST PAGE OF VILLAGE
SCHEDULE AS CROSS CHECK
ngl;o vLg;gth; /; fpuhk ml;ltizapd; Kjy; gf;fj;ijg; rhpghh;g;gjw;F itj;Jf; bfhs;st[k;
Is there a [….] in
this village? IF
NO � NEXT
ROW
fpuhkj;jpy; xU
[….] cs;sjh> ,y;iy vdpy; mLj;j tupirf;Fr; bry;yt[k;
Year of
establishment
Jtf;fg;gl;l tUlk;
Number of patients
treated/ day
xU ehisf;F rpfpr;ir bgWk; nehahspfspd; vz;zpf;if
Open how many
days in a week?
xU thuj;jpy; vj;jid ehs; jpwe;jpUf;Fk;>
No. of hrs. per
day
xU ehisf;F vj;jid kzp neuk; jpwe;jpUf;Fk; >
Male doctors in place
Mz; kUj;Jth; ,Uf;fpwhuh> ,Ue;jhy; vj;jid Mz; kUj;Jtu;fs;>
Female Doctors in Place
bgz; kUj;Jth; ,Uf;fpwhuh> ,Ue;jhy; vj;jid bgz; kUj;Jtu;fs;>
Number of beds
available for
treatment and
delivery rpfpr;ir mspg;gjw;Fk; gpurtk; ghu;g;gjw;Fk; fpilf;Fk; bkhj;j gLf;iffspd; vz;zpf;if
Yes Mk;
No ,y;iy
Yes Mk;
No ,y;iy →→→→ 6 6 6 625252525
Number
vz;zpf;if Yes Mk;
No ,y;iy −−>6−−>6−−>6−−>627272727
Number
vz;zpf;if
5 Sub Centre
Jiz kUj;Jt ikak; 01 02
01 02
01 02
6 Public Sector health facility
bghJj;Jiw kUj;Jt trjpfs; 01 02
01 02
01 02
7 NGO or Trust Hospital / Clinic
bjhz;L epWtdk; my;yJ mwf;fl;lis kUj;Jtkid-fpspdpf;
01 02
01 02
01 02
8 Private Hospital / Nursing Home /
Clinic
jdpahh; kUj;Jtkid-eu;rp’; n\hk;- fpspdpf;
01 02
01 02
01 02
9 Private Medical shop / Pharmacy
jdpahh; kUe;J fil - kUe;J tH’;Fkplk;
01 02
01 02
01 02
Village Qustionnaire – Part B 108
Health Care Facilities INSIDE the Village: Detailed Information
fpuhkj;jpfpuhkj;jpfpuhkj;jpfpuhkj;jpw;F cs;nsw;F cs;nsw;F cs;nsw;F cs;ns mike;Js;s mike;Js;s mike;Js;s mike;Js;s Rfhjhu Rfhjhu Rfhjhu Rfhjhu nrit nrit nrit nrit ikaikaikaika’;fs;’;fs;’;fs;’;fs; ? tp? tp? tp? tpupthd jfty;fs;upthd jfty;fs;upthd jfty;fs;upthd jfty;fs; H
EA
LT
H F
AC
ILIT
Y I
D
Rfhjhu trjpfs; milahs vz;
LIST ALL
FACILITIES
WITHIN THE
VILLAGE LIMITS –
NAMES fpuhk vy;iyf;Fs; fpilf;Fk; vy;yh nrit fisa[k; gl;oayplt[k;
GPS
Reading $p gp v!; fzf;
bfLg;g[
What
year was
the
facility
establishe
d?
YYYY
,e;j ikak; ve;j Mz;L Jtf;fg; gl;lJ>
What type
of health
facility is
this?
,J vd;d tifahd trjp
(Use Codes
given
below) (fPnH bfhLf;fg;gl;Ls;s FwpaPLfis gad;gLj;Jf)
FACILITIES PROVIDED (READ OUT)
Multicoding Possible
tH’;fg;gLk; kUj;Jt trjpfs; (gof;ft[k;) gy gjpy;fs; rhj;jpak;
IF THIS FACILITY OFFERS FAMILY
PLANNING / BIRTH CONTROL
,e;j kUj;Jt kidapy; FLk;g fl;Lg;ghL - FHe;ij gpwg;g[ fl;Lg;ghL
trjpfs; tH’;fg;gLfpd;wdth>
IF THIS FACILITY OFFERS
IMMUNIZATIONS,
,e;j kUj;Jt ikaj;jpy; jLg;g{rpfs;
nghlg;gLfpd;wdth> Which types?
(RANK in order of frequency of
distribution]
ve;j tiffspy;> (kpf mof;fo tH’;fg;gLtjd; mog;gilapy; nu’;f;
gl;oayplt[k;) (Use Codes given below)
(FwpaPLfs; fPnH bfhLf;fg;gl;Ls;sd)
Are the following
Immunizations offered?
fPH; tUk; jLg;g{rpfs; nghlg;gLfpd;wd>
Prenatal
check-
ups
Kd; ngU fhy gupnrhjid
Delivery
gpurtk; Family
Planning /
Birth control
FLk;gf; fl;Lg;ghL - FHe;ij gpwg;g[
fl;Lg;ghL
Immuni
za ions jLg;g{rpfs;
First
Aid
KjYjtp
Nutrition
al
Supplim
ents
Cl;lr; rj;J tH’;fy;
Medicine
s
kUe;J
General
Health
Education /
Advice
bghJ cly; eyf; fy;tp - mwpt[iu
Rank 1
nu’;f;; 1
Code FwpaPL
Rank 2
nu’;f;; 2
Code FwpaPL
Rank 3
nu’;f;; 3
Code
FwpaPL
Polio
nghypnah
Meas
les
jl;lk;ik
BCG
gprp$p DPT
ogpo
Q.no 628. 629. 630. 631. 632. 633. 634.
H1 N 01 02 03 04 05 06 07 08
01 02 03 04
E
H2 N 01 02 03 04 05 06 07 08
01 02 03 04
E
H3 N 01 02 03 04 05 06 07 08
01 02 03 04
E
H4 N 01 02 03 04 05 06 07 08
01 02 03 04
E
H5 N
01 02 03 04 05 06 07 08
01 02 03 04 E
Village Qustionnaire – Part B 109
HE
AL
TH
FA
CIL
ITY
ID
Rfhjhu trjpfs; milahs vz;
LIST ALL
FACILITIES
WITHIN THE
VILLAGE LIMITS –
NAMES fpuhk vy;iyf;Fs; fpilf;Fk; vy;yh nrit fisa[k; gl;oayplt[k;
GPS
Reading $p gp v!; fzf;
bfLg;g[
What
year was
the
facility
establishe
d?
YYYY
,e;j ikak; ve;j Mz;L Jtf;fg; gl;lJ>
What type
of health
facility is
this?
,J vd;d tifahd trjp
(Use Codes
given
below) (fPnH bfhLf;fg;gl;Ls;s FwpaPLfis gad;gLj;Jf)
FACILITIES PROVIDED (READ OUT)
Multicoding Possible
tH’;fg;gLk; kUj;Jt trjpfs; (gof;ft[k;) gy gjpy;fs; rhj;jpak;
IF THIS FACILITY OFFERS FAMILY
PLANNING / BIRTH CONTROL
,e;j kUj;Jt kidapy; FLk;g fl;Lg;ghL - FHe;ij gpwg;g[ fl;Lg;ghL
trjpfs; tH’;fg;gLfpd;wdth>
IF THIS FACILITY OFFERS
IMMUNIZATIONS,
,e;j kUj;Jt ikaj;jpy; jLg;g{rpfs;
nghlg;gLfpd;wdth> Which types?
(RANK in order of frequency of
distribution]
ve;j tiffspy;> (kpf mof;fo tH’;fg;gLtjd; mog;gilapy; nu’;f;
gl;oayplt[k;) (Use Codes given below)
(FwpaPLfs; fPnH bfhLf;fg;gl;Ls;sd)
Are the following
Immunizations offered?
fPH; tUk; jLg;g{rpfs; nghlg;gLfpd;wd>
Prenatal
check-
ups
Kd; ngU fhy gupnrhjid
Delivery
gpurtk; Family
Planning /
Birth control
FLk;gf; fl;Lg;ghL - FHe;ij gpwg;g[
fl;Lg;ghL
Immuni
za ions jLg;g{rpfs;
First
Aid
KjYjtp
Nutrition
al
Supplim
ents
Cl;lr; rj;J tH’;fy;
Medicine
s
kUe;J
General
Health
Education /
Advice
bghJ cly; eyf; fy;tp - mwpt[iu
Rank 1
nu’;f;; 1
Code FwpaPL
Rank 2
nu’;f;; 2
Code FwpaPL
Rank 3
nu’;f;; 3
Code
FwpaPL
Polio
nghypnah
Meas
les
jl;lk;ik
BCG
gprp$p DPT
ogpo
Q.no 628. 629. 630. 631. 632. 633. 634.
H6 N 01 02 03 04 05 06 07 08
01 02 03 04
E
H7 N 01 02 03 04 05 06 07 08
01 02 03 04
E
H8 N 01 02 03 04 05 06 07 08
01 02 03 04
E
H9 N 01 02 03 04 05 06 07 08
01 02 03 04
E
H10 N 01 02 03 04 05 06 07 08
01 02 03 04
E
Village Qustionnaire – Part B 110
Health facility Code Rfhjhu Rfhjhu Rfhjhu Rfhjhu trjpfs; FwpaPLtrjpfs; FwpaPLtrjpfs; FwpaPLtrjpfs; FwpaPL
Public Medical Sector
bghJ kUj;Jtj;Jiw
Private Medical Sector
jdpahh; kUj;Jtj;Jiw
Govt./Municipal Hospital
murh';f-Kdp!pgy; kUj;Jtkid
01 Private Hospital; jdpahh; kUj;Jtkid
13
Govt. Dispensary
murh';f kUe;jfk; 02 Private Doctor / Clinic
jdpahh; kUj;Jtu; - kUe;jfk; 14
UHV/UHP/UFWC
a[b\r;tp - a[b\r;gp - a[v`g;rplgps;a[rp 03 Private mobile clinic
jdpahh; bkhigy; kUe;jfk; 15
CHC/Rural Hospital/PHC
rpb\r;rp- fpuhkg;g[w kUj;Jtkid- Muk;g Rfhjhu ikak; 04 Ayurvedic doctor
[Vaidya/Hakim/Homeopath]
Ma[h;ntj kUj;Jth; (itj;jpau;-\f;fpk;-n\hkpnahgjp
16
Sub Centre Jiz ikak ; 05 Traditional Healer
ghuk;gupa itj;jpau; 17
Govt. Mobile Clinic
murh';f elkhLk; fpspdpf; 06 Pharmacy/ Dispensary
kUe;J fil-kUe;J tH’;Fkplk; 18
Camp Kfhk; (nfk;g;) 07 Dai (TBA)
brtpypj;jha; (ogpV) 19
Anganwadi/ICDS center m';fd;tho-Irpov!; brd;lh; 08 Other private sector health facility
kw;w jdpahh; Jiw Mnuhf;fpa trjpfs; 20
Other Public sector health facility
kw;w bghJj;Jiw Mnuhf;fpa trjpfs; 09 Other kw;wit 21
Other Government/ Public medical facility kw;w murh’;f-bghJ kUj;Jt trjpfs;
10
Don’t know bjupahJ 22
Don’t know bjupahJ 11
NGO or Trust Hospital/Clinic
vd;$pX my;yJ mwf;fl;lis kUj;Jtkid-fpspdpf; 12
Birth Control type
Options Code
Female sterilization bgz;fSf;fhd fUj;jil mWit rpfpr;ir
01
Male sterilization Mz;fSf;fhd fUj;jil mWit rpfpr;ir
02
Pills fUj;jil khj;jpiufs;
03
Injectables / Implants Crp K:yk; brYj;jg;gLtJ-clYf;Fs; bghUj;jg;gLtJ
04
IUD / Loop Ia[o- Y}g;
05
Condom Mqiw
06
Diaphragm (lnah`ghk;) bgz;fSf;fhd fUj;jil rhjdk;
07
Foam / jelly `nghk; - b$y;yp
08
Emergency contraception mtru fhy fUj;jil rhjdk;
09
Induced abortion J}z;lg;gl;l fUf;iyg;g[
10
Others (specify) kw;wit (Fwpg;gplt[k;)
11
Village Qustionnaire – Part B 111
Health: Staff and Facilities--all facilities INSIDE village Rfhjhuk; ? mYtyu;fs; kw;Wk; kUj;Jt trjpfs; ? fpuhkj;jpYs;s vy;yh kUj;Jt trjpfSf;Fk;
HE
ALT
H F
AC
ILIT
Y ID
Rfhjhu trjpfs; milahs vz;
Is the head
of this
facility a
medical
doctor? ,e;j
kUj;Jt ikaj;jpd; jiytu; xU kUj;Jt lhf;luh>
01 = yes
02 = no
01=Mk; 02=,y;iy
How
many
hours a
week
does this
head of
this
facility
work
here? ,e;j
kUj;Jt ikaj;jpd; jiytu; thuj;jpy; vj;jid kzp neuk; ,';F ntiy bra;fpwhu;>
Is the head
of this
facility a
resident of
this village?
,e;j kUj;Jt ikaj;jpd; jiytu; ,e;j
fpuhkj;jpy; trpg;gtuh>
If no
→ 6→ 6→ 6→ 633339999 01 = yes
02 = no
01=Mk; 02=,y;iy
If yes, give name
Mk; vdpy; . bgaiuf; Fwpg;gplt[k;
Number of full time staff
(don't include head) KG neu mYtyu;fspd; vz;zpf;if (jiytiur; nru;f;f ntz;lhk;)
Number of part time staff
(don't include head) gFjp neu mYtyu;fspd; vz;zpf;if
(jiytiur; nru;f;f ntz;lhk;)
How many
patients are
treated in this
facility in a
typical day?
xU ruhrup ehisf;F ,e;j
ikaj;jpy; vj;jid nehahspfs; rpfpr;ir
bgWfpwhu;fs;>
Number of
beds
available for
treatment
and delivery
rpfpr;ir kw;Wk;
gpurtj;jpw;F fpilf;Fk; gLf;iffspd; vz;zpf;if
Is every patient
that enters the
facility
examined by an
Medical Doctor
(MBBS / MD /
MS, etc)?
,e;j ikaj;jpw;Fs; EiHa[k; xt;bthU
nehahspiaa[k; lhf;lu;
gupnrhjpf;fpwhuh> 01 = yes
02 = no
01=Mk;. 02=,y;iy
Does the
facility
have
electricity?
,e;j ikaj;jpy; kpd;trjp cs;sjh>
01 = Yes
02 = No
01=Mk;. 02=,y;iy
Doctors
lhf;lu;fs; Nurses
eu;Rfs; Other F-T
employees
kw;w KGneu
gzpahsh;fs;
Doctors lhf;lu;fs;
Nurses eu;Rfs;
Other P-T
employees
kw;w gFjp neu
gzpahsh;fs;
Name
bgau; HH ID
FLk;g mil ahs vz;
Mem
ber
ID
cWg;gpdu; milahs vz;
M
ale
Mz;
Fem
ale
bgz
;
Male Mz;
Female bgz;
Q.no 635. 636. 637. 638. 639. 640. 641. 642. 643. 644. 645. 646. 647. 648.
H1 01 02
01 02
01 02 01 02
H2 01 02
01 02
01 02 01 02
H3 01 02
01 02
01 02 01 02
H4 01 02
01 02
01 02 01 02
H5 01 02
01 02
01 02 01 02
H6 01 02
01 02
01 02 01 02
H7 01 02
01 02
01 02 01 02
H8 01 02
01 02
01 02 01 02
H9 01 02
01 02
01 02 01 02
H10 01 02
01 02
01 02 01 02
Village Qustionnaire – Part B 112
Health: Staff and Facilities--all facilities within village (cont..) Rfhjhuk; ? mYtyu;fs; kw;Wk; kUj;Jt trjpfs; ? fpuhkj;jpYs;s vy;yh kUj;Jt trjpfSf;Fk; (bjhlu;r;rp)
HE
AL
TH
FA
CIL
ITY
ID
Rfhjhu trjpfs; milahs
vz;
Sunday
“hapW Monday
jp’;fs; Tuesday
brt;tha; Wednesday
g[jd; Total Hours
kept open
jpwe;jpUf;Fk; bkhj;j neuk; T
ime
op
en
jpwf;Fk neuk;
AM
fhiy
PM
khiy
Tim
e cl
osi
ng
K:Lk; neuk;
AM
fhiy
PM
khiy
Total Hours
kept open
jpwe;jpUf;Fk; bkhj;j neuk; T
ime
op
en
jpwf;Fk; neuk;
AM
fhiy
PM
khiy
Tim
e cl
osi
ng
K:Lk; neuk;
AM
fhiy
PM
khiy
Total Hours
kept open
jpwe;jpUf;Fk; bkhj;j neuk; T
ime
op
en
jpwf;Fk; neuk;
AM
fhiy
PM
khiy
Tim
e cl
osi
ng
K:Lk; neuk;
AM
fhiy
PM
khiy
Total Hours
kept open
jpwe;jpUf;Fk; bkhj;j neuk; T
ime
op
en
jpwf;Fk; neuk;
AM
fhiy
PM
khiy
Tim
e cl
osi
ng
K:Lk; neuk;
AM
fhiy
PM
khiy
649. 650. 651. 652. 653. 654. 655. 656. 657. 658. 659. 660.
H1 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02
H2 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02
H3 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02
H4 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02
H5 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02
H6 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02
H7 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02
H8 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02
H9 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02
H10 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02
Village Qustionnaire – Part B 113
H
EA
LT
H F
AC
ILIT
Y
ID
cly; ey trjpfs;
milahs vz; Thursday
tpahHd; Friday
bts;sp Saturday
rdp Total Hours
kept open
jpwe;jpUf;Fk; bkhj;j neuk;
Time
open
jpwf;Fk; neuk; A
M
fhiy
PM
khiy
Time
closing
K:Lk; neuk;
AM
fhiy
PM
khiy
Total Hours
kept open
jpwe;jpUf;Fk; bkhj;j neuk;
Time
open
jpwf;Fk; neuk; A
M
fhiy
PM
khiy
Time
closing
K:Lk; neuk; A
M
fhiy
PM
khiy
Total Hours
kept open
jpwe;jpUf;Fk; bkhj;j neuk;
Time
open
jpwf;Fk; neuk; A
M
fhiy
PM
khiy
Time
closing
K:Lk; neuk; A
M
fhiy
PM
khiy
Q. no 661. 662. 663. 664. 665. 666. 667. 668. 669.
H1 01 02 01 02 01 02 01 02 01 02 01 02
H2 01 02 01 02 01 02 01 02 01 02 01 02
H3 01 02 01 02 01 02 01 02 01 02 01 02
H4 01 02 01 02 01 02 01 02 01 02 01 02
H5 01 02 01 02 01 02 01 02 01 02 01 02
H6 01 02 01 02 01 02 01 02 01 02 01 02
H7 01 02 01 02 01 02 01 02 01 02 01 02
H8 01 02 01 02 01 02 01 02 01 02 01 02
H9 01 02 01 02 01 02 01 02 01 02 01 02
H10 01 02 01 02 01 02 01 02 01 02 01 02
Village Qustionnaire – Part B 114
HE
AL
TH
FA
CIL
ITY
ID
Rfhjhu trjpfs; milahs vz;
If a patient needs more specialized care than can be provided in [----facility], where is the patient generally referred?
xU nehahspf;F (?????kUj;Jt ikak;) ?y; yH’;ff;Toa kUj;Jt nritiatpl mjpf gpuj;jpnahfg; guhkupg;g[ njitg;gl;lhy; . bghJthf me;j nehahsp v’;F bry;y gupe;Jiuf;fg;gLfpwhh;>
Name of referred facility
gupe;Jiuf;fg;gLk; kUj;Jt ikaj;jpd; bgau;
village/town
fpuhkk;- efuk;
CENSUS
CODE
brd;!!; FwpaPL
Taluk
jhYf;fh
CENSUS
CODE
brd;!!; FwpaPL
District
khtl;lk;
CENSUS
CODE
brd;!!; FwpaPL
State
khepyk; CENSUS
CODE
brd;!!; FwpaPL
Distance
(KMs)
bjhiyt[ (fp/kPl;lupy;)
Q.no 670. 671. 672. 673. 674. 675.
H1
H2
H3
H4
H5
H6
H7
H8
H9
H10
Village Qustionnaire – Part B 115
Formal and Informal Financial Institutions for savings, credit, insurance nrkpg;g[ . fld; . fhg;gPl;ow;fhd Kiwahd kw;Wk; Kiwnrkpg;g[ . fld; . fhg;gPl;ow;fhd Kiwahd kw;Wk; Kiwnrkpg;g[ . fld; . fhg;gPl;ow;fhd Kiwahd kw;Wk; Kiwnrkpg;g[ . fld; . fhg;gPl;ow;fhd Kiwahd kw;Wk; Kiwg;g;g;g; gLj;jg;glhj epjp epWtd’;fs;gLj;jg;glhj epjp epWtd’;fs;gLj;jg;glhj epjp epWtd’;fs;gLj;jg;glhj epjp epWtd’;fs;
CODE/ TYPE
FwpaPL - tif Agency
epWtdk; […] In this village?
,e;j fpuhkj;jpy; […] cs;sjh> If yes, Number in this village ?
,e;j fpuhkj;jpy; cs;s vz;zpf;if � NEXT ROW
If None in village, distance of nearest to village/town (km.)
,y;iy vd;why; . mUfhikapy; cs;s Fwpg;gpl;l epWtdk;[ fpuhkj;jpy; - efuj;jpy; ,Ue;J vt;tst[ J}uk;>
Yes Mk; No ,y;iy
→→→→ 676767678888
Q.no 676. 677. 678.
1 Commercial Banks – Public Sector Bank (e.g., SBI)
tzpf hPjpapyhd t’;fpfs; ? bghJj;Jiw t’;fpfs; (cjhuzk; v!;gpI) 01 02
2 Commercial bank: Gramya banks (e.g.,RRBs)
tzpf hPjpapyhd t’;fpfs; ? fpuhkpa t’;fpfs; (cjhuzk; Mu;Mu;gp) 01 02
3 Commercial Bank – private commercial banks (ex: ICICI)
tzpf hPjpapyhd t’;fpfs; ? jdpahh; tzpf hPjpapyhd t’;fpfs; (cjhuzk; ? IrpIrpI)
01 02
4
Commercial Bank – Foreign Bank (ex: HSBC)
tzpf hPjpapyhd t’;fpfs; ? btspehl;L t’;fp (cjhuzk; b\r;v!;gprp) 01 02
6 Cooperative Commercial Bank Tl;Lwt[ tzpf t’;fp 01 02
7 Agricultural credit societies tptrhaf; fld; cjtp r’;f’;fs; 01 02
8 Non-agricultural credit societies tptrhak; my;yhj kw;w fld; cjtp r’;f’;fs; 01 02
9 Other credit societies kw;w fld; tH’;Fk; r’;f’;fs; 01 02
10 Insurance agent fhg;gpl;L Kftu; 01 02
11 Post Office m”;ry; epiyak; 01 02
12 Other (specify) kw;wit (Fwpg;gplt[k;) 01 02
Informal institutions Kiwrhuh epWtd’;fs; /;
13 Self help Groups (SHGs) Ra cjtp FGf ;fs ; 01 02
14 Micro Finance Institutions (MFIs) FW epjp epWtd’ ;fs ; 01 02
15 Other Non-banking financial institutions (like Nidhi companies, etc)
kw ;w t’ ;fprhuh epjp epWtd’ ;fs ; (cjhuzk ; epjp epWtd’ ;fs ; ,ju) 01 02
16 Professional money lenders tl;of;F gzk; bfhLg;gtu; 01 02
17 Chit funds rpl; `gz;L fk;bgdpfs; 01 02
18 Other informal institutions kw;w Kiwrhuh epWtd’;fs; 01 02
Village Qustionnaire – Part B 116
Details on each financial institution in village, or within walking distance of this village ,e;j fpuhkj;jpy; my;yJ ,e;j fpuhkj;jpypUe;J eil J}uj;jpy; cs;s epjp epWtd’;fs; xt;bthd;iwa[k; gw;wpa tpupthd jfty;fs;
Fin
anci
al i
nst
uti
tion
F
AC
ILIT
Y ID
epjp epWtdj;jpd; milahs vz;
LIST ALL INSTITUTIONS – Write
complete Name
vy;yh epWtd’;fisa[k; gl;oayplt[k; ? KGg; bgaiua[k; vGjt[k; [note: i. If there are 2 Commercial Banks
it would be listed as separate institutions
ii. If person, Record Name of the Person
and the Institution associated with]
(Fwpg;g[ ? 1 ) ,uz;L tu;j;jf t’;fpfs; ,Ue;jhy;;. jdpj;jdp epWtd’;fshf vGjt[k;/ 2) ? jdp egu; vdpy; mtupd; bgaiu Fwpg;gpl;L mtu; rhh;e;jpUf;Fk; epWtdj;ij Fwpg;gplt[k;
Type
CODE
(from
previous
page)
tifapd; FwpaPL (Ke;ija gf;fj;jpy; ,Ue;J) Refer Q
676
nfs;tp nfs;tp nfs;tp nfs;tp vz; 676 vz; 676 vz; 676 vz; 676 I I I I ghh;f;ft[k;ghh;f;ft[k;ghh;f;ft[k;ghh;f;ft[k;
GPS Reading
$p gp v!; fzf;bfLg;g[
Year of
establishment
Jtf;fg;gl;l tUlk;
YYYY
Name of highest
official or lender
caujpfhup my;yJ fld; bfhLg;gth; bgau;
If he
resides in
the same
village his
HH ID
mtu; ,nj fpuhkj;jpy; trpf;fpwhh; vdpy; FLk;g milahs vz;
MEMBER
ID
FLk;g cWg;gpdu; vz;
Is this
institution a
branch of
some other
institution
,e;j epWtdk; ntW epWtdj;jpd; fpisah>
Take
deposits
itg;g[ epjpfs; vLj;Jf; bfhs;sg; gLfpwjh>
Interest on
deposits (%)?
KjyPl;Lf;fhd tl;o (%)?
Give Loans.
fld;fs; jug;gLfpwjh>
Average
Interest on
Loans
(%)?
fld;fSf;fhd ruhrup tl;o (%)?
Yes
Mk;
No ,y;iy
Yes
Mk;
No ,y;iy →→ →→
68
8
Yes
Mk;
No ,y;iy
->N
EX
T R
OW
Q.no 679. 680. 681. 682. 683. 684. 685. 686. 687. 688. 689.
FI
N:
01 02 01 02
01 02
E:
F2
N:
01 02 01 02
01 02
E:
F3
N:
01 02 01 02
01 02
E:
F4
N:
01 02 01 02
01 02
E:
F5
N:
01 02 01 02
01 02
E:
F6
N:
01 02 01 02
01 02
E:
Village Qustionnaire – Part B 117
Fin
anci
al i
nst
uti
tion
F
AC
ILIT
Y ID
epjp epWtdj;jpd; milahs vz;
LIST ALL INSTITUTIONS – Write
complete Name
vy;yh epWtd’;fisa[k; gl;oayplt[k; ? KGg; bgaiua[k; vGjt[k; [note: i. If there are 2 Commercial Banks
it would be listed as separate institutions
ii. If person, Record Name of the Person
and the Institution associated with]
(Fwpg;g[ ? 1 ) ,uz;L tu;j;jf t’;fpfs; ,Ue;jhy;;. jdpj;jdp epWtd’;fshf vGjt[k;/ 2) ? jdp egu; vdpy; mtupd; bgaiu Fwpg;gpl;L mtu; rhh;e;jpUf;Fk; epWtdj;ij Fwpg;gplt[k;
Type
CODE
(from
previous
page)
tifapd; FwpaPL (Ke;ija gf;fj;jpy; ,Ue;J) Refer Q
676
nfs;tp nfs;tp nfs;tp nfs;tp vz; 676 vz; 676 vz; 676 vz; 676 I I I I ghh;f;ft[k;ghh;f;ft[k;ghh;f;ft[k;ghh;f;ft[k;
GPS Reading
$p gp v!; fzf;bfLg;g[
Year of
establishment
Jtf;fg;gl;l tUlk;
YYYY
Name of highest
official or lender
caujpfhup my;yJ fld; bfhLg;gth; bgau;
If he
resides in
the same
village his
HH ID
mtu; ,nj fpuhkj;jpy; trpf;fpwhh; vdpy; FLk;g milahs vz;
MEMBER
ID
FLk;g cWg;gpdu; vz;
Is this
institution a
branch of
some other
institution
,e;j epWtdk; ntW epWtdj;jpd; fpisah>
Take
deposits
itg;g[ epjpfs; vLj;Jf; bfhs;sg; gLfpwjh>
Interest on
deposits (%)?
KjyPl;Lf;fhd tl;o (%)?
Give Loans.
fld;fs; jug;gLfpwjh>
Average
Interest on
Loans
(%)?
fld;fSf;fhd ruhrup tl;o (%)?
Yes
Mk;
No ,y;iy
Yes
Mk;
No ,y;iy →→ →→
68
8
Yes
Mk;
No ,y;iy
->N
EX
T R
OW
Q.no 679. 680. 681. 682. 683. 684. 685. 686. 687. 688. 689.
F7
N:
01 02 01 02
01 02
E:
F8
N:
01 02 01 02
01 02
E:
F9
N:
01 02 01 02
01 02
E:
F10
N:
01 02 01 02
01 02
E:
F11
N:
01 02 01 02
01 02
E:
F12
N:
01 02 01 02
01 02
E: