Surveypoint

Q01

Total no. of user HHs

Q02

Can you read and write

Q03

Total number of ME users

Q04

Number of Hamlets in Village

Q05

Population and Total HH in Each Hamlet

Q06

Name of the Hamlet

Q07

Total HH in Each Hamlet

Q08

Total Population in Each Hamlet

Q09

No. of MLINDA mini-grid users (HH)

Q10

No. of MLINDA mini-grid users (ME)

Q11

Caste Wise Distribution

Q11A

Caste

Q11B

Total HH

Q12

Religion Wise Distribution

Q12A

Religion

Q12B

Total HH

Q13

What is the primary source of drinking water?

River

Canal

Pond

Rains

Others (Specify)

Q14

What is the primary source of water for farming purpose?

River

Canal

Pond

Rains

Others (Specify)

Q15

Is there a school in the village?

Yes

No

Q16

If yes, what kind of school is it?

Primary School (1-5)

Upper Primary/Middle School (6-8)

Secondary School (9-10)

Q17

Type of electricity connection in the school?

Grid Electricity

Solar power

Mini Grid

Diesel generator (Owned)

Diesel generator (Supplier)

Kerosene

No Electricity

Others (specify)

Q18

Is there a PHC in the village?

Yes

No

Q19

What is the primary source of electricity in the PHC?

Grid Electricity

Solar power

Mini Grid

Diesel generator (Owned)

Diesel generator (Supplier)

Kerosene

No Electricity

Others (specify)

Q20

Is there an AWC in the village?

Yes

No

Q21

What is the primary source of electricity in the AWC?

Yes

No

Grid Electricity

Solar power

Mini Grid

Diesel generator (Owned)

Diesel generator (Supplier)

Kerosene

No Electricity

Others (specify)

Q22

List of Other Institutions/Buildings in the Village (Religious Places/Community Halls, etc.)

Q23

Are there any irrigation pumps in the village?

Yes

No

Q24

Source of energy for the Pumps

Q24A

Diesel

Q24B

Kerosene

Q24C

Grid Electricity

Q24D

Mini Grid

Q24E

Others (Specify)

Q25

Average Amount Spent (Per Month)

Q25A

Diesel

Q25B

Kerosene

Q25C

Grid Electricity

Q25D

Mini Grid

Q25E

Others (Specify)

Q26

Ownership Pattern ( Owned/On Rent)

Q26A

Diesel

Q26B

Kerosene

Q26C

Grid Electricity

Q26D

Mini Grid

Q26E

Others (Specify)

Q27

How far is the nearest electricity board located? (Specify the distance in KMs)

Q28

Is there a transformer in the village?

Yes

No

Q29

Does a main road pass through the village?

Yes

No

Q30

What is the most popular mode of the transport usually used by individuals for travelling to the nearby town/relative’s place?

Bus

Van

Auto

Cycle

Bike

Others (Specify)

None

Q31

What is the most popular mode of the transport usually used by individuals for transporting crops/products?

Bus

Van

Auto

Cycle

Bike

Others (Specify)

None

Q32

What are the various SHGs operational in the village?

Q33

Are MFIs operational in the village? If Yes, Provide Details such as name, average amount of loan, type of loans

Q34

Which is the most preferred bank for the villagers?

Q35

What is the major occupation of the villagers?

Q36

Primary Source of electricity for Households

Grid Electricity

Solar power

Mini Grid

Diesel generator (Owned)

Diesel generator (Supplier)

Kerosene

No Electricity

Others (specify)

Q36A

Average Amount Spent (Per Month)

Q37

What is the average price of Kerosene? Rs/Litre

Q38

What is the average price of Diesel? Rs/Litre

Q39

What is the average price of Petrol? Rs/Litre

Q40

Village Template Template 5 -Form Fill

Total no. of user HHs

Can you read and write

Total number of ME users

Number of Hamlets in Village

Population and Total HH in Each Hamlet

Name of the Hamlet

Total HH in Each Hamlet

Total Population in Each Hamlet

No. of MLINDA mini-grid users (HH)

No. of MLINDA mini-grid users (ME)

Caste Wise Distribution

Caste

Total HH

Religion Wise Distribution

Religion

Total HH

What is the primary source of drinking water?

What is the primary source of water for farming purpose?

Is there a school in the village?

If yes, what kind of school is it?

Type of electricity connection in the school?

Is there a PHC in the village?

What is the primary source of electricity in the PHC?

Is there an AWC in the village?

What is the primary source of electricity in the AWC?

List of Other Institutions/Buildings in the Village (Religious Places/Community Halls, etc.)

Are there any irrigation pumps in the village?

Source of energy for the Pumps

Diesel

Kerosene

Grid Electricity

Mini Grid

Others (Specify)

Average Amount Spent (Per Month)

Diesel

Kerosene

Grid Electricity

Mini Grid

Others (Specify)

Ownership Pattern ( Owned/On Rent)

Diesel

Kerosene

Grid Electricity

Mini Grid

Others (Specify)

How far is the nearest electricity board located? (Specify the distance in KMs)

Is there a transformer in the village?

Does a main road pass through the village?

What is the most popular mode of the transport usually used by individuals for travelling to the nearby town/relative’s place?

What is the most popular mode of the transport usually used by individuals for transporting crops/products?

What are the various SHGs operational in the village?

Are MFIs operational in the village? If Yes, Provide Details such as name, average amount of loan, type of loans

Which is the most preferred bank for the villagers?

What is the major occupation of the villagers?

Primary Source of electricity for Households

Average Amount Spent (Per Month)

What is the average price of Kerosene? Rs/Litre

What is the average price of Diesel? Rs/Litre

What is the average price of Petrol? Rs/Litre

What is average size of the land held by individuals?