Beruflich Dokumente
Kultur Dokumente
Conducted by
4. Demography
Age groups (Yrs.) No.s of household Members Attendant at birth
5. Education
Technical
Graduates (those Undergraduates
undergoing Graduates (those
who have (those who
School going College going Technical who have
completed currently not
Education completed
education) studying)
education)
M F T M F T M F T M F T M F T M F T
Household Survey
Planning Workshop II: Development Plan for MKPA, West Bengal 1
6. Occupation
No.s of Workers in household Occupation Type
Non -
Marginal working adult Working in Working in Working in
Total Main (Daily Wage Members Primary Secondary Tertiary Retired
Earner) (Age >18, Sector Sector Sector
not studying)
M F T M F T M F T M F T M F T M F T M F T M F T
7. Household Assets Owned (Tick the correct options & mention no.s)
8.1 Land Area (in sq mt) 8.2 Building Area (in sq mt)
8.3 Refrigerator Y / N ( No.s ) 8.4 Television (Colour / BW) Y / N ( No.s )
8.5 Telephone Y / N ( No.s ) 8.6 Washing machine Y / N ( No.s )
8.7 Computer Y / N ( No.s ) 8.8 Internet Y / N ( No.s )
Motor cycle / scooter / Bi- Cell phone Y / N ( No.s )
cycle / Cycle Rickshaw / Car/
8.9 Vehicles 8.10
Van / Tractor / Lorry / Truck / [mention Connection] [ ]
Auto –rickshaw / Bullock cart
8. Solid Waste
9.1 Any systematic garbage collection system available? Y / N
9.2 Any place is earmarked specifically for garbage dumping? Y / N Place ( )
9.3 Is there any arrangement for Door-to-Door collection? Y / N
9.4 Is waste-bins are provided for dumping solid waste? Y / N
9.5 Daily solid waste generated (in Kg.)
9. Approx. Time Taken to Travel from Home and Mode of Travel to the following
Present Mode of Travel Total Travel
Mode- 1 Mode- 2 Mode- 3
Sl. Purpose Ti Expenditu
Co K Time Cod Time Co me Km Time
Km Km re
de m (min) e (min) de (mi
n)
11.1 Work Place
11.2 School
11.3 Market
11.4 Shopping
11.5 Medical
11.6 Recreation*
11.7 Railway Stn
11.8 Bus Stop
Tourist Places
Visited (in
11.9 3yrs)
Mode of Transportation: Walk = W, Public Bus = P, Institutional Transport = I, Rail = R, Taxi = T, Auto = A, Self-Own
Car = S,
Scooter/ Motor Bike = B, Cycle = C, Other = O,
“ * ” – Recreation includes – Social Interaction(SI), Religious (R), Parks (P), etc
Household Survey
Planning Workshop II: Development Plan for MKPA, West Bengal 2
10. Order of various levels of facilities & services
Health Place Distance
12.1 Dispensary/Clinic/OPD
12.2 Community level Health Centers
12.3 District Level
Education
12.4 Primary School
12.5 Secondary School
12.6 Higher Secondary School
12.7 University Level
Trade And Commerce
12.8 Daily Market
12.9 Weekly Market
12.10 Occasional Shopping
Tourist Places
12.11 Religious Places
12.12 Historical Importance
11. Income
14.1 Monthly household income from all Abov
sources Rs.0– Rs.2500– Rs.5000 Rs.7500- Rs.12500 Rs17500 e
2500 5000 –7500 12500 –175000 -25000 25000
14.2 Do you have a Bank Account Y/N
14.3 Source of other income
18.3 Are you satisfied, If not how much you can Y or N (Amount in Rs.)
afford
18.4 Nature of Dwelling *One-storied = 1 *Two-storied = 2
*Multi-storied = 3 * Flat = 4
*Slum hut = 5 *Others =6 _______________
18.5 No. of Habitable Rooms Excluding Bathrooms, Kitchen
18.13 Condition of House *Good = 1 *Average = 2 *Poor = 3
18.14 Total area Occupied (sq. ft.)
Household Survey
Planning Workshop II: Development Plan for MKPA, West Bengal 3
18.16 Un-paved area (sq. ft.) Open area
18.23 Source of Water *Own tap = 1 *Community tap = 2,
*Own tube well = 3 *Community tube well = 4
*Own well = 5 *Community well = 6
*Tank = 7 *Own tap and well = 8
*Own tap and tube well = 9
18.25 Avg. hour of water supply per day
18.26 Volume of water supply is adequate Y/N
18.27 Quality of water supplied * Good quality = 1 *Appears turbid =
2
*Difference in taste and odour are felt = 3
18.29 Maintenance of open drains *Maintained frequently = 1
*Improper cleaning of drains = 2
*Helps in breeding of mosquitoes = 3
*Produces very bad smell = 4
*Stagnant water filled with garbage = 5
18.30 Water logging *No water logging = 1
*Water logging observed immediately after rain
=2
*Water logging after rain, continues for hours =
3
*Water logging for days are observed = 4
18.31 Mosquito net required (Y/N)
18.32 Types of Kitchen *Separate = 1 *In living room = 2 *In
verandah = 3
*Shared=4, *Other =5 _____________________
18.33 Fuel used for cooking *Dung cake = 1 *Fire wood = 2 *Coal = 3
*Gas = 4 *Kerosene = 5 *Electricity =
6
*Biogas = 7 *Others
=8____________________
18.34 Monthly expenditure on cooking fuel in Rs.
18.36 No. of electrical appliances
No. of fans
No. of bulbs
No. of CFLs
Sewage
Water Supply Improvement Housing
Solid Waste Management Shopping
Recreation/ Entertainment Citizen
Service
Household Survey
Planning Workshop II: Development Plan for MKPA, West Bengal 4
School Street Lighting
Health Care Others
(Specify) ____________
NB: Assign Rank 1 to Highest Priority
Household Survey
Planning Workshop II: Development Plan for MKPA, West Bengal 5