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1. Name of the Respondent
   
 
 
 
2. Age
<= 22 22-44 45-64 65+
 
 
 
3. Gender
 
Male
 
Female
 
 
 
4. Education Qualification
 
Illiterate
 
Graduate
 
Technical education
 
Primary (upto 10th std)
 
Post Graduate
 
Secodary (upto +2)
 
Doctorate
 
 
 
5. Occupation

 
Business
 
Employee
 
Executive
 
Domestic
 
Profession
 
Student
 
 
 
6. Monthly income
 
<5000
 
13000 - 17000
 
5000 - 9000
 
>17000
 
9000 - 13000
 
 
 
7. Marital status
 
Single
 
Married
 
 
 
8. Nature of Family
 
nuclear
 
Joint
 
 
 
9. Family size
 
2
 
3-5
 
6 and above
 
 
 
10. Number of earning members in family
 
<= 2
 
3 - 5
 
6 and above
 
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