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Socio-Demographic Data Collection Tool

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guri.eng00
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8 views3 pages

Socio-Demographic Data Collection Tool

Uploaded by

guri.eng00
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

DATA COLLECTION TOOL

PART—A
SOCIO-DEMOGRAPHIC PROFILE
INSTRUCTIONS:

 Kindly give appropriate response to following questions.

 Do not leave any question unattended

 Place a tick ( ) an appropriate response

 Confidentiality of information will be maintained

1. Age ( in years)

a. 30 - 35 ()

b. 25 - 30 ()

c. 35 - 40 ()

2. Area of residence

a. Rural ()

b. Urban ()

3. Gender

a. Male

b. Female

4. Religion

a. Hindu ()

b. Muslim ()

c. Sikh ()

d. others ()

5. Source of information regarding first aid management ( Tick the appropriate)

a. Peer group ()
b. Relative ()

c. Health personnel ()

d. Mass media ()

e. Others ()

6. History of any previous illness.

a. Yes ()

b. No ()

7. Type of family.

a. Nuclear ()

b. Joint ()

c. Extended ()

8. Monthly family income.

a. 20000-25000 ()

b. 25000-30000 ()

c. 30000-35000 ()

d.35000-40000 ()

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