For Help please Contact

Dr. Bidhan Chandra Dash

Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in

Survey Questionnaire
Ethnographic and Demographic Survey of Bairwas and Kapadias in Delhi
Notice

This is to notify that the present research on the Ethnographic and Demographic
information is conducted on behalf of Government of NCT Delhi. The views articulated by
the respondents will be kept strictly confidential. The data gathered will be used entirely for
purposes of research and record.

Instructions

1. Please fill the questionnaire legibly as far as possible

2. Please feel free to attach additional sheets in case you feel the need to do so.
3. Please provide photocopies of documents to substantiate your fact wherever it is necessary. Such as
photocopies of photo identification proof, BPL Card etc.
4. You can Mail or e-mail the Questionnaire to the address given below
Dr. Bidhan Chandra Dash
School of Liberal Studies
Ambedkar University, Delhi
Lothian Road
Kashmere Gate
Delhi: 110006
e-mail: bidhan@aud.ac.in

Thanking you for your cooperation

Yours faithfully

Bidhan Chandra Dash

(Project Coordinator)
 For Help Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in
Questionnaire No.: ______ Contact No.___________________Date_______/________/_20
Section: A
Family/ Household and Personal Information
1. Name of the Respondent:___________________________________

2. Present Address 3. Permanent Address

4. Name of the District._________________________

5. House No._______________________
6. Head of Household: ______________________________
7. Photo Identification: Type________________ No:_______________ (Please
furnish Photocopy for the same)
8. Do you have a BPL Card?
9. If yes, Card No.
10. Your Religion_____________
11. Category: Scheduled Caste Scheduled Tribe General
12. Marital Status:
13. No. of Children
14. Specify the Name of your Community_______________

2
 For Help please Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in

15. Number of Members in the Family_________________

16. Details of the Family/ Household

Sr. Name of Household Member Relation to Age Sex Marital If Married, Literacy Occupation
No. (Mark H against the name of the the (M/ Status No of (Years of (please
Head of the Family) Respondent 1. F) Children Education) mention all in
case of more
than one)
1.

2.

3.

4.

5.

6.

7.

9.
 For Help Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in
10.

11.

12.

4
 For Help please Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in

Section-B
Employment, Income and Housing Details

1. Please describe your employment engagement in the table given below

Sr. Name of Household Primary Secondary 2. No. 3. Tenure Unit of Income/

No. Member employmen employmen Employm wage Wage
t t, if any ent (Daily,
Monthly,
Annual)
1.

2.

3.

4.

5.

6.

7.

9.

10.

11.

12.
 For Help Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in

2. How many members of your household are employed in Government Services?

3. What is the nature of government employment?

4. In case you are unemployed, what do you think is the reason for your
unemployment, please specify below

5. Are you Self-employed? Yes/ No.

6. If Yes, what is the nature of your employment

7. Do you have a family business? Yes./ No.

8. If yes, what is the nature of your business?

9. Do you own land (Either as individual or family)? Yes./ No.

10. Please specify the area of ownership in hectres.

11. Please specify the Net value of the Land as on the date of survey.

12. What is the type of your land ownership? (please the appropriate choice)
a. Seasonal crop irrigated
b. Seasonal crop unirrigated
c. Orchards and plantations(including forest
d. Area put to non- agricultural uses
e. Water bodies
f. Exclusively for non-farm business
g. Other non-agricultural uses
h. Residential area including housesite
i. Other areas, please specify

13. What is the nature of your housing? (please the appropriate choice)
a. Rented
b. Own a house

6
 For Help Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in
c. What is the nature of your housing?
14. What is the type of house you live? (please the appropriate choice)
a. Own Kacha,
b. Own Pakka,
c. Rented Kacha
d. Rented Kacha
e. Govt Accommodation,
f. Ancestral,
g. any other, (please specify)

15. If you own a house, what is the total area floor of your house?

16. What is the net value of your house as per the date of survey?

17. If rented a house, what is the monthly rent you pay for your house?

18. Do you pay a security deposit for the house you rent? Yes. / No.

19. If yes, what is the amount of the security deposit?

20. What is the total monthly estimated income of your family, specify below?

21. What is the total annual estimated income of your family, specify below?

7
 For Help Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in

22. Please share any other information you want to mention regarding your employment
and income in the space given below.

8
 For Help please Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in

Section-C
Information Related to Education

1. Please specify the education and literacy level of your household in the table given
below?

Sr. Name of Household Member Age Sex Literate Type of 4. Specify the last
No. or Non Educati degree
literate on obtained with
(Vocational year
/ General/
Professiona
l)
1.

2.

3.

4.

5.

6.

7.

9.

10.

11.

12.
 For Help Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in
2. Please specify the level of education attended by your family members in different
categories given below. Please give numbers.
a. Primary School
b. Middle School
c. Secondary
d. Higher Secondary
e. Higher Education
f. Technical Education
g. Professional Education

3. What is the reason for leaving education? Please specify in the space given below.

4. How many members of your family have dropped out of school in the age group of 2-
6?

5. How many members of your family have dropped out of school in the age group of 7-
16?

6. What do you think is the main reason for leaving school?

7. Which is the nearest school available for your childrens education? Please provide
the name of the school?

8. What is the distance of the school from your house?

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 For Help Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in

Section-D
Caste Discrimination and Exclusion
1. What is the name of your Caste?

2. How do you think your caste group came to existence?

3. What is the origin of your caste?

4. Do you think that your caste is considered to be low?

5. Do you think that your caste is considered as Untouchable Caste?

6. Do you think that you are recognized as Untouchable caste in you present location in
NCT Delhi?

7. How the people in your neighbourhood did came to know that you belong to a
particular Caste?

8. Please provide some specific instances where you think you have been treated as
Untouchable in the space provided below?

11
 For Help Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in

9. Do you think you are treated as Untouchable in your work place?

10. How the people in your work place did came to know that you belong to a particular
caste group? Please write in the space provided below. (You can also attach a separate
sheet to answer this question)

11. Have you experienced discrimination in your school because of your caste?

12. Do you think that your children are discriminated because of their caste in the schools
and classrooms?
13. Do you think that this caste-based discrimination could be one of the reasons for
which you or your children dropped out of the school?
14. If yes, please narrate some specific instances where you felt that either you or your
children were discriminated because of your Caste? Please use the space given below
or attach a separate sheet for your answer.

12
 For Help Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in

15. Do you think that you are discriminated on the basis of your caste while seeking
employment in government services?
16. If yes, Please narrate some specific instances where you felt such discrimination
taking place?

13
 For Help Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in

17. Do you think that you are discriminated on the basis of your caste while seeking
employment in private enterprises services?
18. If yes, Please narrate some specific instances where you felt such discrimination
taking place?

14
 For Help Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in

19. Do you think that you are discriminated on the basis of your caste while opening new
business ventures?
20. If yes, Please narrate some specific instances where you felt such discrimination
taking place?

15
 For Help Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in
21. Do you think that you are discriminated on the basis of your caste in accessing public
services and facilities?
22. If yes, Please narrate some specific instances where you felt such discrimination
taking place?

16
 For Help Contact
Dr. Bidhan Chandra Dash
Ambedkar University, Delhi
E-mail: bidhan@aud.ac.in
Declaration
I, ____________________________________ hereby declare that the information given
here is correct and true to the best of my knowledge.

(Signature of the Respondent)

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