Survey Text

Nepal 1996
Nepal 2001
Nepal 2006
Nepal 2011
Nepal 2016
top
Nepal 1996
Survey form view entire document:  text 
INTERVIEWER VISITS

FIRST VISIT
DATE
INTERVIEWER'S NAME
RESULT*

NEXT VISIT:
DATE
TIME

SECOND VISIT
DATE
INTERVIEWER'S NAME
RESULT*

NEXT VISIT:
DATE
TIME

THIRD VISIT
DATE
INTERVIEWER'S NAME
RESULT*

FINAL VISIT
DAY
MONTH
YEAR
NAME
RESULT


top
Nepal 2001
Survey form view entire document:  text 
INTERVIEWER VISITS

DATE

DAY __
MONTH __
YEAR ____

INTERVIEWER'S NAME ___________
INT. CODE ________

RESULT* ___

COMPLETED 1
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) ___________________ 7

NEXT VISIT

DATE ________
TIME ________

LANGUAGE

LANGUAGE OF QUESTIONNAIRE: ENGLISH

LANGUAGE OF INTERVIEW

NEPALI 1
BHOJPURI 2
MAITHILI 3
THARU 4
OTHER 5

HOME LANGUAGE OF RESPONDENT

NEPALI 1
BHOJPURI 2
MAITHILI 3
THARU 4
OTHER 5

WAS A TRANSLATOR USED

YES 1
NO 2

top
Nepal 2006
Survey form view entire document:  text 
INTERVIEWER VISITS

FIRST VISIT
DATE
INTERVIEWER NAME
RESULT

COMPLETED 1
NO HOUSEHOLD MEMBER AT HOME OR COMPETENT RESPONDENT IN HOUSEHOLDAT TIME OF VISIT 2
ENTIRE HOUSEHOLD ABSENT FOR EXTENDED PERIOD OF TIME 3
POSTPONED 4
REFUSED 5
DWELLING VACANT OR ADDRESS NOT A DWELLING 6
DWELLING DESTROYED 7
DWELLING NOT FOUND 8
OTHER (SPECIFY)_________ 9

NEXT VISIT:
DATE
TIME

SECOND VISIT
DATE
INTERVIEWER NAME
RESULT

COMPLETED 1
NO HOUSEHOLD MEMBER AT HOME OR COMPETENT RESPONDENT IN HOUSEHOLDAT TIME OF VISIT 2
ENTIRE HOUSEHOLD ABSENT FOR EXTENDED PERIOD OF TIME 3
POSTPONED 4
REFUSED 5
DWELLING VACANT OR ADDRESS NOT A DWELLING 6
DWELLING DESTROYED 7
DWELLING NOT FOUND 8
OTHER (SPECIFY)_________ 9

NEXT VISIT:
DATE
TIME

THIRD VISIT
DATE
INTERVIEWER NAME
RESULT

COMPLETED 1
NO HOUSEHOLD MEMBER AT HOME OR COMPETENT RESPONDENT IN HOUSEHOLDAT TIME OF VISIT 2
ENTIRE HOUSEHOLD ABSENT FOR EXTENDED PERIOD OF TIME 3
POSTPONED 4
REFUSED 5
DWELLING VACANT OR ADDRESS NOT A DWELLING 6
DWELLING DESTROYED 7
DWELLING NOT FOUND 8
OTHER (SPECIFY)_________ 9

FINAL VISIT
DAY
MONTH
YEAR
INT. NUMBER
RESULT

COMPLETED 1
NO HOUSEHOLD MEMBER AT HOME OR COMPETENT RESPONDENT IN HOUSEHOLDAT TIME OF VISIT 2
ENTIRE HOUSEHOLD ABSENT FOR EXTENDED PERIOD OF TIME 3
POSTPONED 4
REFUSED 5
DWELLING VACANT OR ADDRESS NOT A DWELLING 6
DWELLING DESTROYED 7
DWELLING NOT FOUND 8
OTHER (SPECIFY)_________ 9

TOTAL NUMBER OF VISITS


top
Nepal 2011
Survey form view entire document:  text 
INTERVIEWER VISITS

VISIT 1

DATE _____________
INTERVIEWER'S NAME _____________
RESULT _____________

COMPLETED 1
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) __________ 7

NEXT VISIT:
DATE _____________
TIME _____________

VISIT 2

DATE _____________
INTERVIEWER'S NAME _____________
RESULT _____________

COMPLETED 1
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) __________ 7

NEXT VISIT:
DATE _____________
TIME _____________

VISIT 3

DATE _____________
INTERVIEWER'S NAME _____________
RESULT _____________

COMPLETED 1
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) __________ 7

NEXT VISIT:
DATE _____________
TIME _____________

FINAL VISIT

DAY_____________
MONTH _____________
YEAR _____________
INT. NUMBER _____________
RESULT_____________

COMPLETED 1
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) __________ 7

TOTAL NUMBER OF VISITS

LANGUAGE OF QUESTIONNAIRE: ENGLISH

LANGUAGE OF INTERVIEW _____________

NATIVE LANGUAGE OF RESPONDENT _____________


top
Nepal 2016
Survey form view entire document:  text 
INTERVIEWER VISITS

FIRST VISIT
DATE
INTERVIEWER NAME
RESULT*

COMPLETED 1
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY)_________ 7

NEXT VISIT:
DATE
TIME

SECOND VISIT
DATE
INTERVIEWER NAME
RESULT*

COMPLETED 1
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY)_________ 7

NEXT VISIT:
DATE
TIME

THIRD VISIT
DATE
INTERVIEWER NAME
RESULT*

COMPLETED 1
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY)_________ 7

FINAL VISIT
DAY
MONTH
YEAR
INT. NUMBER
RESULT*

COMPLETED 1
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY)_________ 7