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Household Template 35 -Form Fill

Information
Q01

SCHEDULE IDENTIFICATION NUMBER
Q02

Name of the State
Q03

Name of the District
Q04

Name of the Block
Q05

Name of Panchayat
Q06

Name of the Village
Q07

Type of Village
Q08

Household structure number
Q09

Name of household head
Q10

Address of Household
Q11

Interviewer Code
Q12

Interviewer Name
Q13

Interviewer’s Visits

Q13A1

Date-1
Q13A2

Date-2
Q13A3

Date-3
Q13B1

results-1
Q13B2

results-2
Q13B3

results-3
HOUSEHOLD PROFILE
A01

Name of the respondent
A02

What is the sex of respondent?
A03

What is the religion of your household?
A04

Do you belong to a scheduled caste, scheduled tribe, other backward class or general class?
A05

How many members are there in your household?
A06

What is the type of your household?
A07

Does your household own this house or any other house?
A08

How many rooms are there in this house?
A09

Is your household a woman headed household?
A10

What is the level of education of the head of the household?
A11

Does your household have a bank account?
A12

Does your household have a post-office account?
A13

Do you have any owned agricultural land?
A14

Do you have any leased (leased-in) agricultural land?
A15

Do you have any leased (leased-out) agricultural land?
A16

Please specify, the size of your land
A17

What type of fuel does your household mainly use for cooking?
A18

What is the main source of lighting in this household?

A19

Does your household possess ration card?
A20

If yes in item 115 which type of ration card (code) do you posses?
A21

Are there any members of your household who are currently residing outside?
A22

How many members of your households are currently residing outside?
A23A

Name of the Member
A23B

Gender
A23C

Age
A23D

Current Place of Residence
A23E

Reason of Migration
A23F

Period Since Leaving the Household (in Years)
A23G

In the past one Year, in which months did the migration take place?
A24

How many earning members are there in the household?

A25

What is the source of income from following occupations of the household?

A26A

Whether this activity is undertaken by any member of the household?

A26A_1

Agriculture
A26A_2

Agricultural Labour
A26A_3

Non-Agricultural Labour

A26A_4

Livestock

A26A_5

Salaried

A26A_6

Petty Business/Shop

A26A_7

Business/Trader
A26A_8

Skilled Worker
A26A_9

Pension

A26A_10

Remittance

A26A_11

Other (Specify)
A26B

What was the annual income from this activity?

A26B_1

Agriculture
A26B_2

Agricultural Labour
A26B_3

Non-Agricultural Labour

A26B_4

Livestock

A26B_5

Salaried

A26B_6

Petty Business/Shop

A26B_7

Business/Trader
A26B_8

Skilled Worker
A26B_9

Pension

A26B_10

Remittance

A26B_11

Other (Specify)
A26C

What was the annual expense for this activity?

A26C_1

Agriculture
A26C_2

Agricultural Labour
A26C_3

Non-Agricultural Labour

A26C_4

Livestock

A26C_5

Salaried

A26C_6

Petty Business/Shop

A26C_7

Business/Trader
A26C_8

Skilled Worker
A26C_9

Pension

A26C_10

Remittance

A26C_11

Other (Specify)
A27

Does your household own any of the mentioned assets?

A27_1

Mattress

A27_2

Pressure cooker

A27_3

Chair

A27_4

Cot or bed

A27_5

Table

A27_6

Sewing machine

A27_7

Other type of telephone

A27_8

Watch or clock

A27_9

Bicycle

A27_10

Motorcycle or scooter

A27_11

Animal-drawn cart

A27_12

Car

A27_13

Thresher

A27_14

Tractor

ELECTRICITY SUPPLY & DEMAND
B01

What are the current sources of lighting in your household?

B01A

Primary Source (Select only one)
B01B

Average daily supply of the following (In hours)
B01C

Other Source of Lighting (Multiple Responses)
B01D

Average supply of the following (In hours)
B02

What is the average daily requirement of electricity in your household?
B03

Is your energy demand being currently met?
B04

Where is the light installed at your home?
B05

Does your household also have the following items?

B05_1

Electric fan
B05_2

Radio or transistor
B05_3

Black and white television
B05_4

Colour television
B05_5

Mobile telephone
B05_6

Computer/laptop
B05_7

Refrigerator
B05_8

Water pump
B05_9

Internet

B05_10

Air Conditioner or Cooler
B05_11

Washing Machine
B06

What is the primary source of electricity that you use for operating this appliance?
B07

For how many hours is it operated in a day?
B07_1

Electric fan
B07_2

Radio or transistor
B07_3

Black and white television
B07_4

Colour television
B07_5

Mobile telephone
B07_6

Computer/laptop
B07_7

Refrigerator
B07_8

Water pump
B07_9

Internet

B07_10

Air Conditioner or Cooler
B07_11

Washing Machine
B08

Who are the members of the household who use this appliance?
B09

Do you face any of the following issues with respect to the primary source of electricity?

B09_1

Light Fluctuation
B09_2

Low Voltage
B09_3

Disruption in Supply (Irregular Supply)
B09_4

Bad or poor supply during Rainy season or during bad weather
B09_5

Meter Availability (No meter is there, and they want one)
B09_6

Difficult to contact in case of any problem
B10

On a scale of 5, how satisfied are you with the following with respect to the primary source

B10_1

Price of Electricity
B10_2

Quality of light
B10_3

Regularity
DECISION MAKING ON ELECTRICITY USAGE
C01

Who usually takes the decision about the purchase of electricity in the household?
C02

Who normally takes the decision about the purpose for which electricity is to be used?
C03

Who took the decision of the location of the light to be installed at home?
C04

Who normally takes the decision of the usage of shared electrical devices?
BENEFITS OF ELECTRICITY ON EDUCATION
D01_1

Are there any children in the household?
D01_2

Total Number of Children in your Household?
D01_3

How many of them are above five years?
D02

How many of these children in your household go to school?
D03

Do children in your household study after dark?

D04

For how many hours, do the children study after dark?
D05

What are the main reasons for not being able to study after dark?
BENEFITS OF ELECTRICITY ON HEALTH & SAFETY
E01

Has anyone in your household suffered from injuries in the dark due to unavailability of electricity?
E02

Has there been any incidence of fire due to explosion of kerosene lanterns due to unavailability of electricity?
E03

Has there been any incidence of eye problems due to the fuel used for electricity?
E04

Has there been any incidence of coughing due to the fuel used for electricity?
HOUSEHOLD FOOD EXPENDITURE DURING LAST MONTH (30 DAYS)
F01

Please tell me how much of these items have been consumed by the household in the past 30 days?

F01A

Whether consumed?

F01A_1

Rice (KG)
F01A_2

Wheat and Wheat flour (KG)
F01A_3

Sugar, Jaggery (Gur) & other sweeteners (Includes candy, misri, honey) (KG)
F01A_4

Pulses and pulse products (includes soyabean, grams) (kg)
F01A_5

Other cereals like Maize, Jowar, Bajra and their products (kg)

F01A_6

Milk & Milk Products like Ghee, butter, ice-cream, curd (dahi), paneer, etc. (KG)

F01A_7

Vegetables (Including ginger, garlic) (KG)
F01A_8

Meat/fish/chicken/egg (kg)
F01A_9

Edible oil & Vanaspati (LITER)
F01A_10

Salt & Spices (include dry chillies, curry powder, oilseeds etc.)
F01A_11

Other food items like tea, coffee, processed foods such as biscuits, cake, pickles, sauce, etc.
F01A_12

Fruits & nuts (includes mango, banana, coconut, dates, kishmish, monacco, other dry fruits etc.)
F01A_13

Paan, Tobacco, Alcohol etc
F01B

How much (kgs)?

F01B_1

Rice (KG)
F01B_2

Wheat and Wheat flour (KG)
F01B_3

Sugar, Jaggery (Gur) & other sweeteners (Includes candy, misri, honey) (KG)
F01B_4

Pulses and pulse products (includes soyabean, grams) (kg)
F01B_5

Other cereals like Maize, Jowar, Bajra and their products (kg)

F01B_6

Milk & Milk Products like Ghee, butter, ice-cream, curd (dahi), paneer, etc. (KG)

F01B_7

Vegetables (Including ginger, garlic) (KG)
F01B_8

Meat/fish/chicken/egg (kg)
F01B_9

Edible oil & Vanaspati (LITER)
F01B_10

Salt & Spices (include dry chillies, curry powder, oilseeds etc.)
F01B_11

Other food items like tea, coffee, processed foods such as biscuits, cake, pickles, sauce, etc.
F01B_12

Fruits & nuts (includes mango, banana, coconut, dates, kishmish, monacco, other dry fruits etc.)
F01B_13

Paan, Tobacco, Alcohol etc
F01C

Was this home grown

F01C_1

Rice (KG)
F01C_2

Wheat and Wheat flour (KG)
F01C_3

Sugar, Jaggery (Gur) & other sweeteners (Includes candy, misri, honey) (KG)
F01C_4

Pulses and pulse products (includes soyabean, grams) (kg)
F01C_5

Other cereals like Maize, Jowar, Bajra and their products (kg)

F01C_6

Milk & Milk Products like Ghee, butter, ice-cream, curd (dahi), paneer, etc. (KG)

F01C_7

Vegetables (Including ginger, garlic) (KG)
F01C_8

Meat/fish/chicken/egg (kg)
F01C_9

Edible oil & Vanaspati (LITER)
F01C_10

Salt & Spices (include dry chillies, curry powder, oilseeds etc.)
F01C_11

Other food items like tea, coffee, processed foods such as biscuits, cake, pickles, sauce, etc.
F01C_12

Fruits & nuts (includes mango, banana, coconut, dates, kishmish, monacco, other dry fruits etc.)
F01C_13

Paan, Tobacco, Alcohol etc
F01D

How much did you pay for the food item consumed in past 30 days?

F01D_1

Rice (KG)
F01D_2

Wheat and Wheat flour (KG)
F01D_3

Sugar, Jaggery (Gur) & other sweeteners (Includes candy, misri, honey) (KG)
F01D_4

Pulses and pulse products (includes soyabean, grams) (kg)
F01D_5

Other cereals like Maize, Jowar, Bajra and their products (kg)

F01D_6

Milk & Milk Products like Ghee, butter, ice-cream, curd (dahi), paneer, etc. (KG)

F01D_7

Vegetables (Including ginger, garlic) (KG)
F01D_8

Meat/fish/chicken/egg (kg)
F01D_9

Edible oil & Vanaspati (LITER)
F01D_10

Salt & Spices (include dry chillies, curry powder, oilseeds etc.)
F01D_11

Other food items like tea, coffee, processed foods such as biscuits, cake, pickles, sauce, etc.
F01D_12

Fruits & nuts (includes mango, banana, coconut, dates, kishmish, monacco, other dry fruits etc.)
F01D_13

Paan, Tobacco, Alcohol etc
F01E

How much would have cost you to purchase the food item consumed in past 30 days?

F01E_1

Rice (KG)
F01E_2

Wheat and Wheat flour (KG)
F01E_3

Sugar, Jaggery (Gur) & other sweeteners (Includes candy, misri, honey) (KG)
F01E_4

Pulses and pulse products (includes soyabean, grams) (kg)
F01E_5

Other cereals like Maize, Jowar, Bajra and their products (kg)

F01E_6

Milk & Milk Products like Ghee, butter, ice-cream, curd (dahi), paneer, etc. (KG)

F01E_7

Vegetables (Including ginger, garlic) (KG)
F01E_8

Meat/fish/chicken/egg (kg)
F01E_9

Edible oil & Vanaspati (LITER)
F01E_10

Salt & Spices (include dry chillies, curry powder, oilseeds etc.)
F01E_11

Other food items like tea, coffee, processed foods such as biscuits, cake, pickles, sauce, etc.
F01E_12

Fruits & nuts (includes mango, banana, coconut, dates, kishmish, monacco, other dry fruits etc.)
F01E_13

Paan, Tobacco, Alcohol etc
HOUSEHOLD NON-FOOD EXPENDITURE
G01

On average, in a month, how much your household spend on

G01_1

Rent / Housing
G01_2

Healthcare
G01_3

Basic Education (Expense on books, clothes, coaching)
G01_4

Toilet Articles (Includes toothpaste, hair oil, shaving blades etc.)
G01_5

Household Items (Includes bulb, tube light, glassware, soaps, bucket etc.)
G01_6

Entertainment (includes cinema, sports, picnic, club fees etc.), cable, internet
G01_7

Telephone and mobile charges

G01_8

On travelling (like railway, Bus, auto-rickshaw fare
G01_9

Clothing and footwear
G01_10

Gift to relatives, ceremony, social functions
HOUSEHOLD EXPENDITURE ON ENERGY (FUEL, LIGHT & HOUSEHOLD APPLIANCES) DURING THE LAST MONTH (30 DAYS)
H01

Please tell me how much was spent on these items by the household in the past 30 days?

H01_1

Firewood (kg)
H01_2

Grid electricity (unit)
H01_3

dung cake
H01_4

Kerosene
H01_5

LPG

H01_6

Coal

H01_7

petrol (litre)
H01_8

diesel (litre)
H01_9

Solar home lighting system
H01_10

Mini grid

HOUSEHOLD ASSETS AND SAVINGS INFORMATION DURING LAST YEAR
I01

Did you buy the following asset in the last one year?

I01_1

Land or house or other property
I01_2

Livestock

I01_3

Jewellery

I01_4

Vehicle like scooter, tractor etc.
I01_5

Electrical Appliances
I01_6

Solar Panel

I01_7

Any other large asset?
I02

How much money did you spend on purchasing this asset in the last one year?

I02_1

Land or house or other property
I02_2

Livestock

I02_3

Jewellery

I02_4

Vehicle like scooter, tractor etc.
I02_5

Electrical Appliances
I02_6

Solar Panel

I02_7

Any other large asset?
I03

How much money did your household save in the last year?

I03_1

Land or house or other property
I03_2

Livestock

I03_3

Jewellery

I03_4

Vehicle like scooter, tractor etc.
I03_5

Electrical Appliances
I03_6

Solar Panel

I03_7

Any other large asset?
WOMEN’S TIME USE
J01

How many women are there in the household in the age range of 15years or above?
J02

In a regular day of 24 hours, how many hours do you spend in the below mentioned activities?

J02_1

Engage in agricultural activities at home?
J02_2

Engage in agricultural labor working for others?

J02_3

Engage in non-agricultural income generating activities?
J02_4

Study time at home or school?

J02_5

Spend on domestic work including cooking, cleaning, shopping, fetching water, etc.?
J02_6

Spend on leisure, social, and religious activities like radio listening, television viewing, doing prayers, talking, communication, travelling?
J02_7

Capacity building and training etc.
MALE TIME USE
K01

How many men are there in the household in the age range of 15 years or above?
K02

In a regular day of 24 hours, how many hours do you spend in the below mentioned activities?

K02_1

Engage in agricultural activities at home?
K02_2

Engage in agricultural labour working for others?
K02_3

Engage in non-agricultural income generating activities?
K02_4

Study time at home or school?
K02_5

Spend on domestic work including cooking, cleaning, shopping, fetching water, etc.?
K02_6

Spend on leisure, social, and religious activities like radio listening, television viewing, doing prayers, talking, communication, travelling?
K02_7

Capacity building and training etc.
CHILD TIME USE
L01

How many children are there in the household in the age range of 10 to 15 years?
L02

In a regular day of 24 hours, how many hours do you spend in the below mentioned activities?

L02_1

Spend in school?
L02_2

Spend in studying at home?
L02_3

Spend in playing, leisure and social activities like radio listening, television viewing, talking, and travelling?
L02_4

Spend on domestic work including cooking, cleaning, shopping, fetching water, etc.?
L02_5

Engage in income generating activities?
AGRICULTRE TOTAL PRODUCTION AND SALES IN LAST ONE YEAR
M01

What crops did you grow in the last one year?
M02

Total expense on crop production
M03

Total Crop production
M04

Out of total crop production, how much is sold
M05

How much was sold outside the village?
M06

Unsold
M07

Was this crop irrigated?
M08

Was irrigation pump used for irrigation?
M09

What is primary source of energy to operate this pump?