IDENTIFICATION
STATE __
DISTRICT __
TEHSIL/TALUK __
CITY/TOWN/VILLAGE __
TYPE OF PSU (URBAN = 1, RURAL = 2) __
PSU NUMBER __
STRUCTURE NUMBER __
HOUSEHOLD NUMBER __
NAME AND LINE NUMBER OF WOMAN __
ADDRESS OF HOUSEHOLD __
IS HOUSEHOLD SELECTED FOR THE STATE MODULE? (YES =1, NO =2) __
IS WOMAN SELECTED FOR QUESTIONS ON HOUSEHOLD RELATIONS (SECCTION 11)? (YES =1, NO =2) __