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Rojgaar Sewak -Form Fill
Section One
Q01
Code of the Interviewer
Q02
Name of the Interviewer
Q03
Start Time
Q04
Gram Panchayat code
Q05
GPS coordinates (GP office)
Respondent Information
A01
Name of respondent
A02
Designation of respondent
A03
How many GPs fall under your jurisdiction?
A04
Contact number
A05
Gender
Male
Female
Others
A06
Age
A07
Educational qualification
No formal education
Upto class 8th
Upto class 10th
Upto class 12th
Graduation
Post-graduation and above
Scheme Records
B01
How many new application were given for MNREGA job card in last 3 months
B01A
44348
B01B
44378
B01C
44409
B02
How many new MNREGA job cards were made in last 3 months
B02A
44348
B02B
44378
B02C
44409
B03
How many job card application are pending
B03A
44348
B03B
44378
B03C
44409
B04
Kindly provide the figures for work under MGNREGA, in the following categories, in the last three months?
B04A
Number of job applications filled
B04A1
44348
B04A2
44378
B04A3
44409
B04B
Individuals offered work
B04B1
44348
B04B2
44378
B04B3
44409
B04C
Individuals offered work within 15 days of application
B04C1
44348
B04C2
44378
B04C3
44409
B04D
Individuals offered unemployment wages (in case of unavailability of work)
B04D1
44348
B04D2
44378
B04D3
44409
B05
Have any individual livelihood assets been created under MNREGA in this Gram panchayat, in the last 3 months
Yes
No
B06
What type of work has been done under MNREGA in this Gram panchayat , in the last 3 months?
Land levelling
Pond construction
Irrigation Channel de siltation
Building trenches
Anganwadi works
Vermi/NADEF compost pits
Soak pits
Construction of roads
Infrastructure for fisheries (fish drying yards, storage facilities etc.)
Work on agriculture land (farm ponds, check dams, etc.)
Construction of house under Awas Yojana
Vermiculture
Fodder production for livestock
Cattle and poultry shed
Others
B06A
44348
Land levelling
Pond construction
Irrigation Channel de siltation
Building trenches
Anganwadi works
Vermi/NADEF compost pits
Soak pits
Construction of roads
Infrastructure for fisheries (fish drying yards, storage facilities etc.)
Work on agriculture land (farm ponds, check dams, etc.)
Construction of house under Awas Yojana
Vermiculture
Fodder production for livestock
Cattle and poultry shed
Others
B06B
44378
Land levelling
Pond construction
Irrigation Channel de siltation
Building trenches
Anganwadi works
Vermi/NADEF compost pits
Soak pits
Construction of roads
Infrastructure for fisheries (fish drying yards, storage facilities etc.)
Work on agriculture land (farm ponds, check dams, etc.)
Construction of house under Awas Yojana
Vermiculture
Fodder production for livestock
Cattle and poultry shed
Others
B06C
44409
Land levelling
Pond construction
Irrigation Channel de siltation
Building trenches
Anganwadi works
Vermi/NADEF compost pits
Soak pits
Construction of roads
Infrastructure for fisheries (fish drying yards, storage facilities etc.)
Work on agriculture land (farm ponds, check dams, etc.)
Construction of house under Awas Yojana
Vermiculture
Fodder production for livestock
Cattle and poultry shed
Others
B07
What is the percentage of assets created under the following categories out of the total assets under MNREGA, in the last 3 months
B07A
Community assets
B07A1
44348
B07A2
44378
B07A3
44409
B07B
Individual assets
B07B1
44348
B07B2
44378
B07B3
44409
B08
What percent of assets created under the various categories have been functional till date?
B08A
Community assets
None
Less than 10%
10-24%
25-49%
50-74%
75-99%
All assets (100%)
No assets constructed under this category
B08B
Individual assets
None
Less than 10%
10-24%
25-49%
50-74%
75-99%
All assets (100%)
No assets constructed under this category
B09
What percent of card holders, under the following categories, get their wages on time, in the last 3 months
B09A
MNREGA work wages
B09A1
44348
None
Less than 10%
10-24%
25-49%
50-74%
75-99%
All card holders (100%)
Not applicable
B09A2
44378
None
Less than 10%
10-24%
25-49%
50-74%
75-99%
All card holders (100%)
Not applicable
B09A3
44409
None
Less than 10%
10-24%
25-49%
50-74%
75-99%
All card holders (100%)
Not applicable
B09B
Unemployment wages
B09B1
44348
None
Less than 10%
10-24%
25-49%
50-74%
75-99%
All card holders (100%)
Not applicable
B09B2
44378
None
Less than 10%
10-24%
25-49%
50-74%
75-99%
All card holders (100%)
Not applicable
B09B3
44409
None
Less than 10%
10-24%
25-49%
50-74%
75-99%
All card holders (100%)
Not applicable
B10
How many social audits have been conducted in last 3 months
B10A
44348
B10B
44378
B10C
44409
B11
How many Rojgaar diwas have been conducted in last 3 months
B11A
44348
B11B
44378
B11C
44409
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