Resident Condition Survey

Resident Condition Survey

v1
by
N
Nurika@21
Resident Condition Survey
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Citizen Condition Survey

CITIZEN REGISTRATION

Citizen Condition Survey

FIELD FORM

Family condition data collection

Fill in all questions with the latest data. Grouping results can only be seen by the owner.

Private data
Surveyor identity

Record the officer who conducted the visit.

Family identity

This information is used for recording and field verification.

Family condition

Select the answer that matches the situation during data collection.

Are there any elderly family members?
Are there any family members with disabilities?
Female head of household?
Are there any children currently in school?
Are there any other family members working besides the head of the family?
Access to services and housing conditions

Select the condition that best matches the family's situation during data collection.

Income, assets, expenses

Enter the monthly rupiah value for income and expenses. Assets are calculated as the total estimated value.

Own other land / buildings besides the one occupied?
Notes and images

All questions are mandatory.

FILLED RECAP

Names already surveyed

    Data collection for citizens' socio-economic needs.Access to recap is restricted to the owner.