Annexure

Household Schedule Poverty: Extent, Determinants and Consequences Note: Collected data will be used only for academic exercise and will be kept confidential. A. Identification Village/Mohallah ________ Tehsil/City ________ District ________ State _________ Head of Household ________________ S/o _____________ S. No. of Respondent _____________ B. Basic Demographic Information
Relation to Gender S. Head of (M/F) No. Household 1. 2. 3. 4. Age Education Marital Primary Secondary Annual (Years) Level Status Activity Activity NonAgricultural (Yrs./Qua) (Code) Specify Specify with Code with Code Income (Rs.)

Caste

____________

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5. 6. 7. 8. 9. 10.

Activity Codes : None-0; Cultivator-1; Agricultural Labourer-2; Livestock Rearing-3; Mining-4; Household M, Industry-5A; Other M Industry-5B; Construction-6; Trade-7; Transport-8; Other Services -9; Student-10; Unemployed-11.

C. Capital Assets (Own share only)

Asset 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Unit Built-up Area Non-Agricultural Land Un-irrigated Land Irrigated Land Beed Land Peta Land Cow Bullock Calf Buffalo He Buffalo Calf (Buffalo) Size/No. Asset Unit/Type 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. Goat Sheep Donkey Other (specify) Cart Pump Set Tube-Well Oil Engine Business Establishment Manufacturing Unit Tractors/Trucks/Bus/Taxi Others (Specify) No./Size

D. Consumption Assets
Item Two Wheeler Fan/Cooler Others No. Model Item Sewing Machine Bicycle No. Model

E. Agricultural Production
Kharif Rabi Zaid

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Crop Area-Sown Production Crop Area-Sown Production Crop Area-Sown Production (ha) (quintals) (ha) (quintals) (ha) (quintals)

F.

Livestock Production
Milk (l/yr) Power (day/yr) Stock Goat Sheep Donkey Calf (Buffalo) Other Milk (l/yr) Power (day/yr) Wool (kg/yr)

Stock Cow Bullock Calf Buffalo He Buffalo

G. Consumption
Item Wheat Rice Jowar Bajra Maize Oth. Cereals Pulses Sugar Gur Coffee/ Tea Ghee Veg. Oil Vegetables/ fruits Unit Quintal/yr Quintal/yr Quintal/yr Quintal/yr Quintal/yr Quintal/yr Quintal/yr Kg/month Kg/month Kg/month Kg/month Kg/month kg/day Quantity Source Item Firewood Unit Quantity Source

Quintal/ month Petrol/Diesel Rs./month Gas/Kerosene Rs./month Electricity Bill Rs/month Water Charges Rs/month Clothing Rs./yr Educational Rs./yr Medicine, etc. Rs./yr Others Milk l/day Meat Fish Kg/month Kg/month

H. Case specific observations of the Interviewer about the state of poverty/ well-being and associated conditions. _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________

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Signature and Name of the Interviewer : Date :

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Guidelines for Field Survey Example

Work Part-II P ractical Work in Geography, Part-II

Table 5.1 Surveys Pollution

Item

1. Title and Sub-Title

Land Use Poverty Ground Water Industrial Effluents: Institutional Impacts of Techno-Economic Changes Urban Poverty : Causes Causes and Impacts A Ground Water Depletion and State of Land Use-A and Consequences - A Study of....... - A Case Study of ......... Study of .............. Study of...........

2. Objectives (a) Spatial Coverage (b) Temporal Coverage (c) Thematic Coverage (a) Secondary Information (b) Maps (c) Observations (d) Measurement (e) Interviewing Unit (f) Survey Design (g) Schedule/ Questionnaire (a) Data Entry and Tabulation

3. Coverage

4. Tools and Techniques

5. Compilation (b) Computation of Indices and Computation (c) Visual Presentation (d) Thematic Mapping (e) Statistical Analysis (a) Outline (b) Major Findings

6. Report writing

Item

Survey Example

1. Title and Sub-Title

Energy Issues Drought Floods Soil Degradation Pattern of Energy Sources Deforestation and State of Impact of Drought Costs and Benefits of and Consumption - A Soil Degradation - A Study Condition and Coping Recurring Floods : A Study of ......... of ............ Strategies - A Study of.... Study of.......

2. Objectives (a) Spatial Coverage (b) Temporal Coverage (c) Thematic Coverage (a) Secondary Information (b) Maps (c) Observations (d) Measurement (e) Interviewing Unit (f) Survey Design (g) Schedule/ Questionnaire (a) Data Entry and Tabulation

3. Coverage

4. Tools and Techniques

5. Compilation (b) Computation of Indices and Computation (c) Visual Presentation (d) Thematic Mapping (e) Statistical Analysis (a) Outline (b) Major Findings

6. Report writing

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