APPENDIX 1 / 6 DEMOGRAPHIC PROFILE
NAME : 1._______________ 2._______________ NATURE OF RESPONDANT/RESPONDANTS:
AGE GROUP: A) 15-25 B) 25-35 C) 35-45 D) 45-55 E) 55-65 F) 65-75
GENDER:Male Female
EDUCATIONAL QUALIFICATION 1. Illiterate 2. Upto 10th 3. Upto 12th 4. Graduated 5. Ungraduated
OCCUPATION :1._________________ 2._________________
APPENDIX 2 / 6
MONTHLY INCOME :
1. 5000-15000 2. 15000-25000 3. 25000-35000 4. 35000-45000
GENERAL QUESTIONNAIRE QUES1How many members are there in your family ? No of Households Total Population Male Population Female Population
QUES 3How many children are ther in your family? YES/NO Do they go to school? YES/NO PUBLIC / PRIVATE _______________ QUES 4Do you have a a bank account ? - YES NO Name of the bank ___________________ QUES 5: What percent of income are you able to save per month ? _________ QUES 6: Has any member of your family migrated ?___________ QUES 7:Do you agree that drainage facilities are proper in the village ? Agree ____ Neutral________ Disagree _____
APPENDIX 3 / 6
QUES8: Which health centre do you prefer at the time of medical emergency ? Public / Private
QUES9: Have you observed any developmental changes in the village lately? Mention
QUES 10: Mention any issues being faced by you in the village?
APPENDIX 4 / 6 TOPIC: TO STUDY THE TRANSPORTATION FACILITIES IN THE VILLAGE 1. Do you own any private vehicle? YES / NO If yes, How many? _______ Name
BIKE
CAR
TRACTOR
CYCLE
SCOOTER / SCOOTY
2. Do you use the private vehicle which you own ? – YES / NO If no, why not ?________________
3. Which transport do you prefer more?
PUBLIC / PRIVATE
4. How often do you use public transport?
Daily
Several times a week
Weekly
Several times a month
APPENDIX 5 / 6 5. For what reasons do you use public transport?
Schooling
Job
Medical
Household shopping
Family visits
Places of worship
Any other ____________________
6. What is the route you travel the most ? __________________________________________________________
7. What is the minimum fare you have to pay for the matador ? _____________
8. For how long do you have to wait for the vehicle on an average?
15-20 minutes ______
About an hour ________
1-2 hours ____________
2-3 hours ____________
More than 3 hours____________
9. How many members of your family use public transport ? __________
APPENDIX 6 / 6 10. Do you face the following problems regarding public transport ?
Do you agree the following schemes should be launched in the village?
Overloading
Waiting time
Only Matadors and no other means
Distance to be walked to catch the matador
Which problem according to you is the most critical?_______________Any other problems
11. Do you have a vehicle insurance ? __________ Do you agree that vehicle insurance is important ? Strongly agree ______________ Neutral____________ Strongly Disagree___________
12. SCHEMES
PradhanMantri Gram ParivahanYojana
PRADHAN MANTRI GRAM SADK YOJNA
How much do you agree on the following ? Roads of your village are well connected to other nearby villages