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Project: Epidemiological Profile of Bawana region in North West District of Delhi दिल्ली के उत्तर पश्चिम जिले में बवाना क्षेत्र का महामारी विज्ञान अध्ययनPID 42
My Projects Project Home Project Setup Online Designer Data Dictionary Codebook

The Codebook is a human-readable, read-only version of the project's Data Dictionary and serves as a quick reference for viewing the attributes of any given field in the project without having to download and interpret the Data Dictionary. Note: Checkbox fields have their coded values displayed both in the format defined by users in the Online Designer/Data Dictionary as well as in the extended format seen in data imports and exports (i.e., field___code).

Data Dictionary Codebook 10/19/2025 3:54am
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Data Dictionary Codebook
Project: Epidemiological Profile of Bawana region in North West District of Delhi दिल्ली के उत्तर पश्चिम जिले में बवाना क्षेत्र का महामारी विज्ञान अध्ययन (PID: 42)
10/19/2025 3:54am
Instruments
Instrument Form Name
Form 1 form_1
# Variable / Field Name Field Label
Field Note
 Field Attributes (Field Type, Validation, Choices, Calculations, etc.)
Instrument:Form 1(form_1) Enabled as survey
1 [record_id] Record ID text
2 [mohalla_location] Mohalla/Location
मुहल्ला/स्थान
 text, Required
3 [a_household_composition_of] A. HOUSEHOLD COMPOSITION OF RESPONDENTप्रतिक्रिया देने वाले के घर के सदस्यों की जानकारी descriptive
4 [type_of_family] Type of Family
परिवार का प्रकार 		radio, Required
1Joint / संयुक्त
2Nuclear / एकल
5 [no_of_family_member] No of Family Member radio, Required
11
22
33
44
55
66
6 [monthly_income_from_all_so] Monthly income from all sourcesमहीने के आय सभी से सूत्रों का कहना है text (number), Required
7 [total_monthly_income_of_ho] Total monthly income of household
कुल महीने के की आय परिवार
 text (number), Required
8 [monthly_household_expense] Monthly household expense on Kitchen
महीने के परिवार व्यय रसोई पर
 text (number), Required
9 [house_type] House Typeमकान का प्रकार descriptive
10 [house_type_1] House Type
(मकान का प्रकार ) 		radio, Required
1Kuccha / कच्चा
2Jhopri / झोपड़ी
3Pucca / पक्का
11 [property_owned] Property Owned
स्वामित्व वाली संपत्ति 		yesno, Required
1Yes
0No
12 [type_of_property]
Show the field ONLY if:
[property_owned] = '1'
Type of property radio, Required
1Residential / आवासीय
2Agricultural / कृषि
3Commercial / वाणिज्यिक
4Others / अन्य
13 [specify_other]
Show the field ONLY if:
[type_of_property] = '4'
Specify other text
14 [locality] Locality
इलाका 		radio, Required
1Rural / ग्रामीण
2Semi urban / अर्धशहरी
3Urban / शहरी
4Urban slum / शहरी स्लम
5Urban planned / शहरी नियोजित
15 [household_assets] Household Assets
घरेलू संपत्ति 		checkbox, Required
1household_assets___1A.C. / ए.सी
2household_assets___2Refrigerator/ रेफ्रिजरेटर
3household_assets___3TV / टीवी
4household_assets___4VCR / वीसीआर
5household_assets___5Washing machine/ वॉशिंग मशीन
6household_assets___6Scooter / स्कूटर
7household_assets___7Car / कार
8household_assets___8Other
16 [other_household]
Show the field ONLY if:
[household_assets(8)] = '1'
Specify Other text
17 [domestic_animals] Domestic Animals
घरेलू पशु 		checkbox, Required
1domestic_animals___1Cows / गाय
2domestic_animals___2Buffalos / भैंस
3domestic_animals___3Pigs / सूअर
4domestic_animals___4Horses / घोड़े
5domestic_animals___5Goats / बकरी
6domestic_animals___6Other
18 [specify_other_dom_animal]
Show the field ONLY if:
[domestic_animals(6)] = '1'
Specify other text
19 [kitchen_garden] Kitchen Garden
किचन गार्डन 		yesno, Required
1Yes
0No
20 [domestic_servants] Domestic Servants
घरेलू नौकर 		yesno, Required
1Yes
0No
21 [gender_of_servent]
Show the field ONLY if:
[domestic_servants] = '1'
Gender of Servent radio, Required
1Male
2Female
22 [source_of_water] Source of Water
जल का स्रोत
 radio, Required
1Tap / नल
2Tank / टैंक
3Tube-well / ट्यूबवेल
4Hand or motor pump / हाथ या मोटर पंप
5Pond / तालाब
6Well / कुआं
7River / नदी
8Other
23 [other_source_of_water]
Show the field ONLY if:
[source_of_water] = '8'
Specify other text
24 [kind_of_milk] Kind of Milk
दूध का प्रकार 		radio, Required
1Domestic source/ घरेलू स्रोत
2Milkman / दूधवाला
3Mother dairy/ मदर डेयरी
4Cow / गाय
5Buffalo / भैंस
6Goat / बकरी
7Other
25 [specify_other_milk]
Show the field ONLY if:
[kind_of_milk] = '7'
Specify other text
26 [individual_1]
Show the field ONLY if:
[no_of_family_member] >= 1
First family Member descriptive
27 [sex_1]
Show the field ONLY if:
[no_of_family_member] >= 1
Sex
लिंग 		radio, Required
1Male
2Female
3Other
28 [specify_other_1]
Show the field ONLY if:
[sex_1] = '3'
Specify other text
29 [age_year_month_days_1]
Show the field ONLY if:
[no_of_family_member] >= 1
Age
(Year/Month/Days)
आयु
(वर्ष/महीना/दिन)
Age in years
 text (number, Min: 1, Max: 99), Required
Field Annotation: @FORCE-MINMAX
30 [relationship_with_ego_1]
Show the field ONLY if:
[no_of_family_member] >= 1
Relationship with ego
संबंध अहंकार के साथ
 text, Required
31 [present_marital_status_1]
Show the field ONLY if:
[no_of_family_member] >= 1
Present Marital Status
उपस्थित वैवाहिक स्थिति
 radio, Required
1Single (never married)
2Married
3Widowed
4Divorced
5Separated.
32 [educational_status_1]
Show the field ONLY if:
[no_of_family_member] >= 1
Educational Status
शैक्षणिक स्थिति
 radio, Required
11. Primary / प्राथमिक
22. Secondary / गौण
33. And above /और ऊपर
33 [occupational_status_1]
Show the field ONLY if:
[no_of_family_member] >= 1
Occupational Status
व्यावसायिक स्थिति
 text, Required
34 [any_kind_of_illness_1]
Show the field ONLY if:
[no_of_family_member] >= 1
Any kind of Illness?
किसी तरह का बीमारी?

 yesno, Required
1Yes
0No
35 [name_of_illness_1]
Show the field ONLY if:
[any_kind_of_illness_1] = '1'
Name of illness text, Required
36 [duration_of_illness_1]
Show the field ONLY if:
[any_kind_of_illness_1] = '1'
Duration of illness text
37 [any_treatment_given_1]
Show the field ONLY if:
[any_kind_of_illness_1] = '1'
Any treatment Given?
कोई इलाज दिया गया?
yesno, Required
1Yes
0No
38 [if_yes_what_1]
Show the field ONLY if:
[any_treatment_given_1] = '1'
If yes, what?
अगर हाँ क्या?
 text
39 [nutritional_status]
Show the field ONLY if:
[no_of_family_member] >= 1
Nutritional Status descriptive
40 [dietary_habit_1]
Show the field ONLY if:
[no_of_family_member] >= 1
Dietary Habit
आहार संबंधी आदत 		radio, Required
1Veg / शाकाहारी
2Non-Veg / गैर-शाकाहारी
41 [amount_consumed_water_l_1]
Show the field ONLY if:
[no_of_family_member] >= 1
Amount Consumed water (L/day):
उपभोग की गई राशि पानी (एल/दिन):
 radio, Required
1Less than 0.5 L
20.5 - 1 L
31 - 2 L
42 - 3 L
5More than 3 L
42 [no_of_full_meals_1]
Show the field ONLY if:
[no_of_family_member] >= 1
No of Full Meals:
पूर्ण भोजन की संख्या:
 radio, Required
11 meal/day
22 meals/day
33 meals/day
4More than 3 meals/day

Field Annotation: @FORCE-MINMAX
43 [frequency_non_vegetaria_1]
Show the field ONLY if:
[dietary_habit_1] = '2'
Frequency of Non-Vegetarian Food:
मांसाहारी भोजन की आवृत्ति:
 radio, Required
1Never
2Occasionally (1-2 times/month)
3Weekly (1-2 times/week)
4Frequently (3-5 times/week)
5Daily
44 [frequency_of_vegetarian_1]
Show the field ONLY if:
[no_of_family_member] >= 1
Frequency of Vegetarian Food:
शाकाहारी भोजन की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
45 [frequency_milk_products_1]
Show the field ONLY if:
[no_of_family_member] >= 1
Frequency of Milk Products:
दुग्ध उत्पादों की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
46 [frequency_of_pulses_1]
Show the field ONLY if:
[no_of_family_member] >= 1
Frequency of Pulses:
दालों की आवृत्ति:
 radio, Required
1Never
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
47 [frequency_of_fruits_1]
Show the field ONLY if:
[no_of_family_member] >= 1
Frequency of Fruits:
फलों की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
48 [any_other_specific_diet_1]
Show the field ONLY if:
[no_of_family_member] >= 1
Any other specific diet
कोई अन्य विशिष्ट आहार
 text
49 [any_illness]
Show the field ONLY if:
[no_of_family_member] >= 1
Any Illnessकोई बीमारी descriptive
50 [nutritional_deficiency]
Show the field ONLY if:
[no_of_family_member] >= 1
Nutritional Deficiency
पोषण की कमी
 yesno, Required
1Yes
0No
51 [which_type_of_nutritional]
Show the field ONLY if:
[nutritional_deficiency] = '1'
Which type of Nutritional Deficiency text, Required
52 [age_at_nurition_def]
Show the field ONLY if:
[nutritional_deficiency] = '1'
Age (आयु) - At what age illness started? text (number)
53 [duration_nutrient_def]
Show the field ONLY if:
[nutritional_deficiency] = '1'
Duration (अवधि) - How long did it last? text
54 [physical_disability]
Show the field ONLY if:
[no_of_family_member] >= 1
Physical Disability
शारीरिक अपंगता
 yesno, Required
1Yes
0No
55 [which_type_of_physical_dis]
Show the field ONLY if:
[physical_disability] = '1'
Which type of Physical Disability
 text, Required
56 [duration_how_long_physical]
Show the field ONLY if:
[physical_disability] = '1'
Duration (अवधि) - How long did it last? text
57 [emotional_impairment]
Show the field ONLY if:
[no_of_family_member] >= 1
Emotional Impairment
भावनात्मक क्षति
 yesno, Required
1Yes
0No
58 [which_type_of_emotional_im]
Show the field ONLY if:
[emotional_impairment] = '1'
Which type of Emotional Impairment
 text, Required
59 [duration_how_long_emontiona]
Show the field ONLY if:
[emotional_impairment] = '1'
Duration (अवधि) - How long did it last? text
60 [major_therapeutic_irradiat]
Show the field ONLY if:
[no_of_family_member] >= 1
Major Therapeutic Irradiation Exposure
प्रमुख चिकित्सीय विकिरण एक्सपोजर
 yesno, Required
1Yes
0No
61 [which_type_of_major_therap]
Show the field ONLY if:
[major_therapeutic_irradiat] = '1'
Which type of Major Therapeutic Irradiation Exposure
 text, Required
62 [duration_how_long_major]
Show the field ONLY if:
[major_therapeutic_irradiat] = '1'
Duration (अवधि) - How long did it last? text
63 [long_illness]
Show the field ONLY if:
[no_of_family_member] >= 1
Long Illness
लंबी बीमारी
 yesno, Required
1Yes
0No
64 [which_type_of_long_illness]
Show the field ONLY if:
[long_illness] = '1'
Which type of Long Illness

 text, Required
65 [duration_how_long_ilness]
Show the field ONLY if:
[long_illness] = '1'
Duration (अवधि) - How long did it last? text
66 [g_have_you_ever_been_diagn]
Show the field ONLY if:
[no_of_family_member] >= 1
G. Have you ever been diagnosed by a doctor for any of the following conditions?जी. क्या आपको कभी किसी डॉक्टर द्वारा निम्नलिखित में से किसी भी स्थिति का निदान किया गया है? descriptive
67 [heart_failure_disease]
Show the field ONLY if:
[no_of_family_member] >= 1
Heart failure/disease
हृदय विफलता/बीमारी
 yesno, Required
1Yes
0No
68 [type_heart_disesae]
Show the field ONLY if:
[heart_failure_disease] = '1'
Type
प्रकार 		text
69 [age_heart_faliour]
Show the field ONLY if:
[heart_failure_disease] = '1'
Age
आयु
 text (number)
70 [irritable_bowel_disease]
Show the field ONLY if:
[no_of_family_member] >= 1
Irritable Bowel Disease
चिड़चिड़ा आंत्र रोग
 yesno, Required
1Yes
0No
71 [type_irritable_bowel]
Show the field ONLY if:
[irritable_bowel_disease] = '1'
Type
प्रकार
 text
72 [age_bowel_disease]
Show the field ONLY if:
[irritable_bowel_disease] = '1'
Age
आयु
 text (number)
73 [chronic_bronchitis]
Show the field ONLY if:
[no_of_family_member] >= 1
Chronic Bronchitis
क्रोनिक ब्रोंकाइटिस
 yesno, Required
1Yes
0No
74 [type_bronchitis]
Show the field ONLY if:
[chronic_bronchitis] = '1'
Type
प्रकार
 text
75 [age_bronchitis]
Show the field ONLY if:
[chronic_bronchitis] = '1'
Age
आयु
 text (number)
76 [hernia]
Show the field ONLY if:
[no_of_family_member] >= 1
Hernia
हरनिया
 yesno, Required
1Yes
0No
77 [type_hernia]
Show the field ONLY if:
[hernia] = '1'
Type
प्रकार
 text
78 [age_hernia]
Show the field ONLY if:
[hernia] = '1'
Age
आयु
 text (number)
79 [emphysema]
Show the field ONLY if:
[no_of_family_member] >= 1
Emphysema
वातस्फीति
 yesno, Required
1Yes
0No
80 [type_endometriosis]
Show the field ONLY if:
[emphysema] = '1'
Type
प्रकार
 text
81 [age_endometriosis]
Show the field ONLY if:
[emphysema] = '1'
Age
आयु
 text (number)
82 [arthritis]
Show the field ONLY if:
[no_of_family_member] >= 1
Arthritis
वात रोग
 yesno, Required
1Yes
0No
83 [type_arthritis]
Show the field ONLY if:
[arthritis] = '1'
Type
प्रकार 		text
84 [age_arthritis]
Show the field ONLY if:
[arthritis] = '1'
Age
आयु 		text (number)
85 [inflammatory_bowel_disease]
Show the field ONLY if:
[no_of_family_member] >= 1
Inflammatory bowel disease
सूजा आंत्र रोग
 yesno, Required
1Yes
0No
86 [type_inflammatory_bowel]
Show the field ONLY if:
[inflammatory_bowel_disease] = '1'
Type
प्रकार 		text
87 [age_inflammatory_bowel_disease]
Show the field ONLY if:
[inflammatory_bowel_disease] = '1'
Age
आयु 		text, Required
88 [depression]
Show the field ONLY if:
[no_of_family_member] >= 1
Depression
अवसाद
 yesno, Required
1Yes
0No
89 [type_depression]
Show the field ONLY if:
[depression] = '1'
Type
प्रकार 		text
90 [age_depression]
Show the field ONLY if:
[depression] = '1'
Age
आयु 		text (number)
91 [cancer]
Show the field ONLY if:
[no_of_family_member] >= 1
Cancer
कैंसर
 yesno, Required
1Yes
0No
92 [type_cancer]
Show the field ONLY if:
[cancer] = '1'
Type
प्रकार 		text
93 [age_cancer]
Show the field ONLY if:
[cancer] = '1'
Age
आयु 		text (number)
94 [h_have_you_or_your_family]
Show the field ONLY if:
[no_of_family_member] >= 1
H. Have you or your family member suffered from any of the listed symptoms in last 1 year?क्या आप या आपके परिवार के सदस्य पिछले एक वर्ष में सूचीबद्ध लक्षणों में से किसी से पीड़ित हुए हैं? descriptive
95 [high_fever]
Show the field ONLY if:
[no_of_family_member] >= 1
High fever / तेज़ बुखार yesno, Required
1Yes
0No
96 [when_highg_fever]
Show the field ONLY if:
[high_fever] = '1'
When
कब 		text
97 [how_many_times_fever]
Show the field ONLY if:
[high_fever] = '1'
How many times
कितनी बार
 text
98 [weakness_and_fatigue]
Show the field ONLY if:
[no_of_family_member] >= 1
Weakness and Fatigue
कमज़ोरी और थकान
 yesno, Required
1Yes
0No
99 [when_weakness]
Show the field ONLY if:
[weakness_and_fatigue] = "1"
When
कब 		text
100 [how_many_times_weakness]
Show the field ONLY if:
[weakness_and_fatigue] = "1"
How many times
कितनी बार 		text
101 [muscle_ache]
Show the field ONLY if:
[no_of_family_member] >= 1
Muscle ache
मांसपेशियों में दर्द
 yesno, Required
1Yes
0No
102 [when_muscle]
Show the field ONLY if:
[muscle_ache] = "1"
When
कब 		text
103 [how_many_times_muscle]
Show the field ONLY if:
[muscle_ache] = "1"
How many times
कितनी बार 		text
104 [stomach_pain]
Show the field ONLY if:
[no_of_family_member] >= 1
Stomach pain
पेट दर्द
 yesno, Required
1Yes
0No
105 [when_stomach]
Show the field ONLY if:
[stomach_pain] = "1"
When
कब 		text
106 [how_many_times_stomach]
Show the field ONLY if:
[stomach_pain] = "1"
How many times
कितनी बार 		text
107 [loss_of_appetite_and_weigh]
Show the field ONLY if:
[no_of_family_member] >= 1
Loss of appetite and weight
भूख और वजन में कमी
 yesno, Required
1Yes
0No
108 [when_appetite]
Show the field ONLY if:
[loss_of_appetite_and_weigh] ="1"
When
कब 		text
109 [how_many_times_appetite]
Show the field ONLY if:
[loss_of_appetite_and_weigh] ="1"
How many times
कितनी बार 		text
110 [dry_cough]
Show the field ONLY if:
[no_of_family_member] >= 1
Dry cough
सूखी खाँसी
 yesno, Required
1Yes
0No
111 [when_dry_cough]
Show the field ONLY if:
[dry_cough] = "1"
When
कब 		text
112 [how_many_times_dry_cough]
Show the field ONLY if:
[dry_cough] = "1"
How many times
कितनी बार 		text
113 [diarrhoea]
Show the field ONLY if:
[no_of_family_member] >= 1
Diarrhoea
दस्त
 yesno, Required
1Yes
0No
114 [when_diarrhoea]
Show the field ONLY if:
[diarrhoea] = "1"
When
कब 		text
115 [how_many_times_diarrheaea]
Show the field ONLY if:
[diarrhoea] = "1"
How many times
कितनी बार 		text
116 [hair_fall]
Show the field ONLY if:
[no_of_family_member] >= 1
Hair fall
बाल झड़ना
 yesno, Required
1Yes
0No
117 [when_hair_fall]
Show the field ONLY if:
[hair_fall] = '1'
When
कब 		text
118 [how_many_times_hair_fall]
Show the field ONLY if:
[hair_fall] = '1'
How many times
कितनी बार 		text
119 [itching_and_rashes]
Show the field ONLY if:
[no_of_family_member] >= 1
Itching and rashes
खुजली और चकत्ते
 yesno, Required
1Yes
0No
120 [when_itching]
Show the field ONLY if:
[itching_and_rashes] = "1"
When
कब 		text
121 [how_many_times_itching]
Show the field ONLY if:
[itching_and_rashes] = "1"
How many times
कितनी बार 		text
122 [headaches]
Show the field ONLY if:
[no_of_family_member] >= 1
Headaches
सिर दर्द
 yesno, Required
1Yes
0No
123 [when_headaches]
Show the field ONLY if:
[headaches] = "1"
When
कब 		text
124 [how_many_times_headaches]
Show the field ONLY if:
[headaches] = "1"
How many times
कितनी बार 		text
125 [eye_pain]
Show the field ONLY if:
[no_of_family_member] >= 1
Eye pain
आँख का दर्द
 yesno, Required
1Yes
0No
126 [when_eye_pain]
Show the field ONLY if:
[eye_pain] = "1"
When
कब 		text
127 [how_many_times_eyepain]
Show the field ONLY if:
[eye_pain] = "1"
How many times
कितनी बार 		text
128 [alcohol_locally_fermented]
Show the field ONLY if:
[no_of_family_member] >= 1
Alcohol / Locally Fermented Beer (Mahua, Whisky, Rum, Beer, Other (Mahua; Whisky; Rum; any other / महुआ; व्हिस्की; रम; कोई और) descriptive
129 [who_consumes_alcohol]
Show the field ONLY if:
[no_of_family_member] >= 1
Who consumes alcohol? radio, Required
1You/ आप
2Family member/ परिवार के सदस्य
3Both / दोनों
130 [do_you_consume_alcohol]
Show the field ONLY if:
[no_of_family_member] >= 1
Do you consume alcohol? yesno, Required
1Yes
0No
131 [how_do_you_consume]
Show the field ONLY if:
[do_you_consume_alcohol] = '1'
How do you consume? radio, Required
1Regular/ नियमित
2Occasional/प्रासंगिक
132 [at_what_age_did_you_start]
Show the field ONLY if:
[do_you_consume_alcohol] = '1'
At what age did you start consuming alcohol? text (number), Required
133 [frequency_of_alcohol_consu]
Show the field ONLY if:
[how_do_you_consume] = '1'
Frequency of alcohol consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
5Occasional
134 [quantity_of_alcohol_consum]
Show the field ONLY if:
[how_do_you_consume] = '1'
Quantity of alcohol consumed per day (average in ml): text (number), Required
135 [do_you_take_during_pregnan]
Show the field ONLY if:
[no_of_family_member] >= 1
Do you take during pregnancy?
क्या आप गर्भावस्था के दौरान लेते हैं?
 radio, Required
1Yes
2No
3Not Applicable
136 [frequency_per_day_during_p]
Show the field ONLY if:
[do_you_take_during_pregnan] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
137 [tobacco_pan_chewing_smokin]
Show the field ONLY if:
[no_of_family_member] >= 1
Tobacco / Pan (Chewing, Smoking, Beedi, Cigarette, Zarda, Other ( चबाना; धूम्रपान; प्रत्यक्ष तम्बाकू; बीड़ी; सिगरेट; ज़र्दा; कोई और ) descriptive
138 [who_consumes_tobacco_pan]
Show the field ONLY if:
[no_of_family_member] >= 1
Who consumes tobacco/pan? radio, Required
1You
2Family member
3Both
139 [do_you_consume_tobacco_pan]
Show the field ONLY if:
[no_of_family_member] >= 1
Do you consume tobacco/pan? yesno, Required
1Yes
0No
140 [how_do_you_consume_tobacco]
Show the field ONLY if:
[do_you_consume_tobacco_pan] = '1'
How do you consume tobacco/pan? radio, Required
1Regular
2Occasional
141 [what_form_of_tobacco_pan_d]
Show the field ONLY if:
[do_you_consume_tobacco_pan] = '1'
What form of tobacco/pan do you use? checkbox, Required
1what_form_of_tobacco_pan_d___1Chewing
2what_form_of_tobacco_pan_d___2Smoking
3what_form_of_tobacco_pan_d___3Beedi
4what_form_of_tobacco_pan_d___4Cigarette
5what_form_of_tobacco_pan_d___5Zarda
6what_form_of_tobacco_pan_d___6Other (please specify)
142 [other_specify]
Show the field ONLY if:
[what_form_of_tobacco_pan_d(6)] = '1'
Other Specify text
143 [at_what_age_did_you_tobacco]
Show the field ONLY if:
[do_you_consume_tobacco_pan] = '1'
At what age did you start consuming tobacco/pan? text (number), Required
144 [frequency_of_tobacco_pan_c]
Show the field ONLY if:
[how_do_you_consume_tobacco] = '1'
Frequency of tobacco/pan consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
145 [quantity_consumed_per_day]
Show the field ONLY if:
[how_do_you_consume_tobacco] = '1'
Quantity consumed per day (average): text, Required
146 [do_you_take_tobacco_pan_du]
Show the field ONLY if:
[no_of_family_member] >= 1
Do you take tobacco/pan during pregnancy? radio, Required
1Yes
2No
3Not Applicable
147 [frequency_per_day_tobaco_pre]
Show the field ONLY if:
[do_you_take_tobacco_pan_du] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
148 [other_drugs_charas_ganja_b]
Show the field ONLY if:
[no_of_family_member] >= 1
Other Drugs (Charas, Ganja, Bhang, Opium, LSD, Brown Sugar, Other)(चरस; गांजा; भांग; अफ़ीम; एल.एस.डी.; ब्राउन शुगर; कोई और) descriptive
149 [who_consumes_other_drugs]
Show the field ONLY if:
[no_of_family_member] >= 1
Who consumes other drugs? radio, Required
1You
2Family member
3Both
150 [do_you_consume_other_drugs]
Show the field ONLY if:
[no_of_family_member] >= 1
Do you consume other drugs? yesno, Required
1Yes
0No
151 [how_do_you_consume_other_d]
Show the field ONLY if:
[do_you_consume_other_drugs] = '1'
How do you consume other drugs? radio, Required
1Regular
2Occasional
152 [what_type_of_drug_do_you_u]
Show the field ONLY if:
[do_you_consume_other_drugs] = '1'
What type of drug do you use? checkbox, Required
1what_type_of_drug_do_you_u___1Charas
2what_type_of_drug_do_you_u___2Ganja
3what_type_of_drug_do_you_u___3Bhang
4what_type_of_drug_do_you_u___4Opium
5what_type_of_drug_do_you_u___5LSD
6what_type_of_drug_do_you_u___6Brown Sugar
7what_type_of_drug_do_you_u___7Other (please specify)
153 [specify_other_drug]
Show the field ONLY if:
[what_type_of_drug_do_you_u(7)] = '1'
Specify Other text
154 [at_what_age_did_you_star_drug]
Show the field ONLY if:
[do_you_consume_other_drugs] = '1'
At what age did you start consuming drugs? text (number), Required
155 [frequency_of_drug_consumpt]
Show the field ONLY if:
[how_do_you_consume_other_d] = '1'
Frequency of drug consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
156 [quantity_consumed_per_day_drug]
Show the field ONLY if:
[how_do_you_consume_other_d] = '1'
Quantity consumed per day (average): text (number), Required
157 [do_you_take_drugs_during_p]
Show the field ONLY if:
[no_of_family_member] >= 1
Do you take drugs during pregnancy? radio, Required
1Yes
2No
3Not Applicable
158 [frequency_per_day_during_drug]
Show the field ONLY if:
[do_you_take_drugs_during_p] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
159 [second_family_member]
Show the field ONLY if:
[no_of_family_member] >= 2
SECOND FAMILY MEMBER descriptive
160 [sex_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Sex
लिंग 		radio, Required
1Male
2Female
3Other
161 [specify_other_2]
Show the field ONLY if:
[sex_2] = '3'
Specify other text
162 [age_year_month_days_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Age
(Year/Month/Days)
आयु
(वर्ष/महीना/दिन)
Age in years
 text (number, Min: 1, Max: 99), Required
Field Annotation: @FORCE-MINMAX
163 [relationship_with_ego_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Relationship with ego
संबंध अहंकार के साथ
 text, Required
164 [present_marital_status_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Present Marital Status
उपस्थित वैवाहिक स्थिति
 radio, Required
1Single (never married)
2Married
3Widowed
4Divorced
5Separated.
165 [educational_status_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Educational Status
शैक्षणिक स्थिति
 radio, Required
11. Primary / प्राथमिक
22. Secondary / गौण
33. And above /और ऊपर
166 [occupational_status_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Occupational Status
व्यावसायिक स्थिति
 text, Required
167 [any_kind_of_illness_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Any kind of Illness?
किसी तरह का बीमारी?

 yesno, Required
1Yes
0No
168 [name_of_illness_2]
Show the field ONLY if:
[any_kind_of_illness_2] = '1'
Name of illness text, Required
169 [duration_of_illness_2]
Show the field ONLY if:
[any_kind_of_illness_2] = '1'
Duration of illness text
170 [any_treatment_given_2]
Show the field ONLY if:
[any_kind_of_illness_2] = '1'
Any treatment Given?
कोई इलाज दिया गया?
yesno, Required
1Yes
0No
171 [if_yes_what_2]
Show the field ONLY if:
[any_treatment_given_2] = '1'
If yes, what?
अगर हाँ क्या?
 text
172 [nutritional_status_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Nutritional Status descriptive
173 [dietary_habit_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Dietary Habit
आहार संबंधी आदत 		radio, Required
1Veg / शाकाहारी
2Non-Veg / गैर-शाकाहारी
174 [amount_consumed_water_l_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Amount Consumed water (L/day):
उपभोग की गई राशि पानी (एल/दिन):
 radio, Required
1Less than 0.5 L
20.5 - 1 L
31 - 2 L
42 - 3 L
5More than 3 L
175 [no_of_full_meals_2]
Show the field ONLY if:
[no_of_family_member] >= 2
No of Full Meals:
पूर्ण भोजन की संख्या:
 radio, Required
11 meal/day
22 meals/day
33 meals/day
4More than 3 meals/day

Field Annotation: @FORCE-MINMAX
176 [frequency_non_vegetaria_2]
Show the field ONLY if:
[dietary_habit_2] = '2'
Frequency of Non-Vegetarian Food:
मांसाहारी भोजन की आवृत्ति:
 radio, Required
1Never
2Occasionally (1-2 times/month)
3Weekly (1-2 times/week)
4Frequently (3-5 times/week)
5Daily
177 [frequency_of_vegetarian_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Frequency of Vegetarian Food:
शाकाहारी भोजन की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
178 [frequency_milk_products_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Frequency of Milk Products:
दुग्ध उत्पादों की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
179 [frequency_of_pulses_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Frequency of Pulses:
दालों की आवृत्ति:
 radio, Required
1Never
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
180 [frequency_of_fruits_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Frequency of Fruits:
फलों की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
181 [any_other_specific_diet_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Any other specific diet
कोई अन्य विशिष्ट आहार
 text
182 [any_illness_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Any Illnessकोई बीमारी descriptive
183 [nutritional_deficiency_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Nutritional Deficiency
पोषण की कमी
 yesno, Required
1Yes
0No
184 [which_type_of_nutritional_2]
Show the field ONLY if:
[nutritional_deficiency_2] = '1'
Which type of Nutritional Deficiency text, Required
185 [age_at_nurition_def_2]
Show the field ONLY if:
[nutritional_deficiency_2] = '1'
Age (आयु) - At what age illness started? text (number)
186 [duration_nutrient_def_2]
Show the field ONLY if:
[nutritional_deficiency_2] = '1'
Duration (अवधि) - How long did it last? text
187 [physical_disability_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Physical Disability
शारीरिक अपंगता
 yesno, Required
1Yes
0No
188 [which_type_of_physical_dis_2]
Show the field ONLY if:
[physical_disability_2] = '1'
Which type of Physical Disability
 text, Required
189 [duration_how_long_physical_2]
Show the field ONLY if:
[physical_disability_2] = '1'
Duration (अवधि) - How long did it last? text
190 [emotional_impairment_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Emotional Impairment
भावनात्मक क्षति
 yesno, Required
1Yes
0No
191 [which_type_of_emotional_im_2]
Show the field ONLY if:
[emotional_impairment_2] = '1'
Which type of Emotional Impairment
 text, Required
192 [duration_how_long_emontiona_2]
Show the field ONLY if:
[emotional_impairment_2] = '1'
Duration (अवधि) - How long did it last? text
193 [major_therapeutic_irradiat_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Major Therapeutic Irradiation Exposure
प्रमुख चिकित्सीय विकिरण एक्सपोजर
 yesno, Required
1Yes
0No
194 [which_type_of_major_therap_2]
Show the field ONLY if:
[major_therapeutic_irradiat_2] = '1'
Which type of Major Therapeutic Irradiation Exposure
 text, Required
195 [duration_how_long_major_2]
Show the field ONLY if:
[major_therapeutic_irradiat_2] = '1'
Duration (अवधि) - How long did it last? text
196 [long_illness_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Long Illness
लंबी बीमारी
 yesno, Required
1Yes
0No
197 [which_type_of_long_illness_2]
Show the field ONLY if:
[long_illness_2] = '1'
Which type of Long Illness

 text, Required
198 [duration_how_long_ilness_2]
Show the field ONLY if:
[long_illness_2] = '1'
Duration (अवधि) - How long did it last? text
199 [g_have_you_ever_been_diagn_2]
Show the field ONLY if:
[no_of_family_member] >= 2
G. Have you ever been diagnosed by a doctor for any of the following conditions?जी. क्या आपको कभी किसी डॉक्टर द्वारा निम्नलिखित में से किसी भी स्थिति का निदान किया गया है? descriptive
200 [heart_failure_disease_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Heart failure/disease
हृदय विफलता/बीमारी
 yesno, Required
1Yes
0No
201 [type_heart_disesae_2]
Show the field ONLY if:
[heart_failure_disease_2] = '1'
Type
प्रकार 		text
202 [age_heart_faliour_2]
Show the field ONLY if:
[heart_failure_disease_2] = '1'
Age
आयु
 text (number)
203 [irritable_bowel_disease_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Irritable Bowel Disease
चिड़चिड़ा आंत्र रोग
 yesno, Required
1Yes
0No
204 [type_irritable_bowel_2]
Show the field ONLY if:
[irritable_bowel_disease_2] = '1'
Type
प्रकार
 text
205 [age_bowel_disease_2]
Show the field ONLY if:
[irritable_bowel_disease_2] = '1'
Age
आयु
 text (number)
206 [chronic_bronchitis_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Chronic Bronchitis
क्रोनिक ब्रोंकाइटिस
 yesno, Required
1Yes
0No
207 [type_bronchitis_2]
Show the field ONLY if:
[chronic_bronchitis_2] = '1'
Type
प्रकार
 text
208 [age_bronchitis_2]
Show the field ONLY if:
[chronic_bronchitis_2] = '1'
Age
आयु
 text (number)
209 [hernia_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Hernia
हरनिया
 yesno, Required
1Yes
0No
210 [type_hernia_2]
Show the field ONLY if:
[hernia_2] = '1'
Type
प्रकार
 text
211 [age_hernia_2]
Show the field ONLY if:
[hernia_2] = '1'
Age
आयु
 text (number)
212 [emphysema_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Emphysema
वातस्फीति
 yesno, Required
1Yes
0No
213 [type_endometriosis_2]
Show the field ONLY if:
[emphysema_2] = '1'
Type
प्रकार
 text
214 [age_endometriosis_2]
Show the field ONLY if:
[emphysema_2] = '1'
Age
आयु
 text (number)
215 [arthritis_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Arthritis
वात रोग
 yesno, Required
1Yes
0No
216 [type_arthritis_2]
Show the field ONLY if:
[arthritis_2] = '1'
Type
प्रकार 		text
217 [age_arthritis_2]
Show the field ONLY if:
[arthritis_2] = '1'
Age
आयु 		text (number)
218 [inflammatory_bowel_disease_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Inflammatory bowel disease
सूजा आंत्र रोग
 yesno, Required
1Yes
0No
219 [type_inflammatory_bowel_2]
Show the field ONLY if:
[inflammatory_bowel_disease_2] = '1'
Type
प्रकार 		text
220 [age_inflammatory_bowel_disease_2]
Show the field ONLY if:
[inflammatory_bowel_disease_2] = '1'
Age
आयु 		text, Required
221 [depression_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Depression
अवसाद
 yesno, Required
1Yes
0No
222 [type_depression_2]
Show the field ONLY if:
[depression_2] = '1'
Type
प्रकार 		text
223 [age_depression_2]
Show the field ONLY if:
[depression_2] = '1'
Age
आयु 		text (number)
224 [cancer_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Cancer
कैंसर
 yesno, Required
1Yes
0No
225 [type_cancer_2]
Show the field ONLY if:
[cancer_2] = '1'
Type
प्रकार 		text
226 [age_cancer_2]
Show the field ONLY if:
[cancer_2] = '1'
Age
आयु 		text (number)
227 [h_have_you_or_your_family_2]
Show the field ONLY if:
[no_of_family_member] >= 2
H. Have you or your family member suffered from any of the listed symptoms in last 1 year?क्या आप या आपके परिवार के सदस्य पिछले एक वर्ष में सूचीबद्ध लक्षणों में से किसी से पीड़ित हुए हैं? descriptive
228 [high_fever_2]
Show the field ONLY if:
[no_of_family_member] >= 2
High fever / तेज़ बुखार yesno, Required
1Yes
0No
229 [when_highg_fever_2]
Show the field ONLY if:
[high_fever_2] = '1'
When
कब 		text
230 [how_many_times_fever_2]
Show the field ONLY if:
[high_fever_2] = '1'
How many times
कितनी बार
 text
231 [weakness_and_fatigue_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Weakness and Fatigue
कमज़ोरी और थकान
 yesno, Required
1Yes
0No
232 [when_weakness_2]
Show the field ONLY if:
[weakness_and_fatigue_2] = "1"
When
कब 		text
233 [how_many_times_weakness_2]
Show the field ONLY if:
[weakness_and_fatigue_2] = "1"
How many times
कितनी बार 		text
234 [muscle_ache_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Muscle ache
मांसपेशियों में दर्द
 yesno, Required
1Yes
0No
235 [when_muscle_2]
Show the field ONLY if:
[muscle_ache_2] = "1"
When
कब 		text
236 [how_many_times_muscle_2]
Show the field ONLY if:
[muscle_ache_2] = "1"
How many times
कितनी बार 		text
237 [stomach_pain_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Stomach pain
पेट दर्द
 yesno, Required
1Yes
0No
238 [when_stomach_2]
Show the field ONLY if:
[stomach_pain_2] = "1"
When
कब 		text
239 [how_many_times_stomach_2]
Show the field ONLY if:
[stomach_pain_2] = "1"
How many times
कितनी बार 		text
240 [loss_of_appetite_and_weigh_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Loss of appetite and weight
भूख और वजन में कमी
 yesno, Required
1Yes
0No
241 [when_appetite_2]
Show the field ONLY if:
[loss_of_appetite_and_weigh_2] ="1"
When
कब 		text
242 [how_many_times_appetite_2]
Show the field ONLY if:
[loss_of_appetite_and_weigh_2] ="1"
How many times
कितनी बार 		text
243 [dry_cough_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Dry cough
सूखी खाँसी
 yesno, Required
1Yes
0No
244 [when_dry_cough_2]
Show the field ONLY if:
[dry_cough_2] = "1"
When
कब 		text
245 [how_many_times_dry_cough_2]
Show the field ONLY if:
[dry_cough_2] = "1"
How many times
कितनी बार 		text
246 [diarrhoea_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Diarrhoea
दस्त
 yesno, Required
1Yes
0No
247 [when_diarrhoea_2]
Show the field ONLY if:
[diarrhoea_2] = "1"
When
कब 		text
248 [how_many_times_diarrheaea_2]
Show the field ONLY if:
[diarrhoea_2] = "1"
How many times
कितनी बार 		text
249 [hair_fall_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Hair fall
बाल झड़ना
 yesno, Required
1Yes
0No
250 [when_hair_fall_2]
Show the field ONLY if:
[hair_fall_2] = '1'
When
कब 		text
251 [how_many_times_hair_fall_2]
Show the field ONLY if:
[hair_fall_2] = '1'
How many times
कितनी बार 		text
252 [itching_and_rashes_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Itching and rashes
खुजली और चकत्ते
 yesno, Required
1Yes
0No
253 [when_itching_2]
Show the field ONLY if:
[itching_and_rashes_2] = "1"
When
कब 		text
254 [how_many_times_itching_2]
Show the field ONLY if:
[itching_and_rashes_2] = "1"
How many times
कितनी बार 		text
255 [headaches_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Headaches
सिर दर्द
 yesno, Required
1Yes
0No
256 [when_headaches_2]
Show the field ONLY if:
[headaches_2] = "1"
When
कब 		text
257 [how_many_times_headaches_2]
Show the field ONLY if:
[headaches_2] = "1"
How many times
कितनी बार 		text
258 [eye_pain_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Eye pain
आँख का दर्द
 yesno, Required
1Yes
0No
259 [when_eye_pain_2]
Show the field ONLY if:
[eye_pain_2] = "1"
When
कब 		text
260 [how_many_times_eyepain_2]
Show the field ONLY if:
[eye_pain_2] = "1"
How many times
कितनी बार 		text
261 [alcohol_locally_fermented_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Alcohol / Locally Fermented Beer (Mahua, Whisky, Rum, Beer, Other (Mahua; Whisky; Rum; any other / महुआ; व्हिस्की; रम; कोई और) descriptive
262 [who_consumes_alcohol_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Who consumes alcohol? radio, Required
1You/ आप
2Family member/ परिवार के सदस्य
3Both / दोनों
263 [do_you_consume_alcohol_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Do you consume alcohol? yesno, Required
1Yes
0No
264 [how_do_you_consume_2]
Show the field ONLY if:
[do_you_consume_alcohol_2] = '1'
How do you consume? radio, Required
1Regular/ नियमित
2Occasional/प्रासंगिक
265 [at_what_age_did_you_start_2]
Show the field ONLY if:
[do_you_consume_alcohol_2] = '1'
At what age did you start consuming alcohol? text (number), Required
266 [frequency_of_alcohol_consu_2]
Show the field ONLY if:
[how_do_you_consume_2] = '1'
Frequency of alcohol consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
5Occasional
267 [quantity_of_alcohol_consum_2]
Show the field ONLY if:
[how_do_you_consume_2] = '1'
Quantity of alcohol consumed per day (average in ml): text (number), Required
268 [do_you_take_during_pregnan_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Do you take during pregnancy?
क्या आप गर्भावस्था के दौरान लेते हैं?
 radio, Required
1Yes
2No
3Not Applicable
269 [frequency_per_day_during_p_2]
Show the field ONLY if:
[do_you_take_during_pregnan_2] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
270 [tobacco_pan_chewing_smokin_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Tobacco / Pan (Chewing, Smoking, Beedi, Cigarette, Zarda, Other ( चबाना; धूम्रपान; प्रत्यक्ष तम्बाकू; बीड़ी; सिगरेट; ज़र्दा; कोई और ) descriptive
271 [who_consumes_tobacco_pan_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Who consumes tobacco/pan? radio, Required
1You
2Family member
3Both
272 [do_you_consume_tobacco_pan_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Do you consume tobacco/pan? yesno, Required
1Yes
0No
273 [how_do_you_consume_tobacco_2]
Show the field ONLY if:
[do_you_consume_tobacco_pan_2] = '1'
How do you consume tobacco/pan? radio, Required
1Regular
2Occasional
274 [what_form_of_tobacco_pan_d_2]
Show the field ONLY if:
[do_you_consume_tobacco_pan_2] = '1'
What form of tobacco/pan do you use? checkbox, Required
1what_form_of_tobacco_pan_d_2___1Chewing
2what_form_of_tobacco_pan_d_2___2Smoking
3what_form_of_tobacco_pan_d_2___3Beedi
4what_form_of_tobacco_pan_d_2___4Cigarette
5what_form_of_tobacco_pan_d_2___5Zarda
6what_form_of_tobacco_pan_d_2___6Other (please specify)
275 [other_specify_2]
Show the field ONLY if:
[what_form_of_tobacco_pan_d(6)] = '1'
Other Specify text
276 [at_what_age_did_you_tobacco_2]
Show the field ONLY if:
[do_you_consume_tobacco_pan_2] = '1'
At what age did you start consuming tobacco/pan? text (number), Required
277 [frequency_of_tobacco_pan_c_2]
Show the field ONLY if:
[how_do_you_consume_tobacco_2] = '1'
Frequency of tobacco/pan consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
278 [quantity_consumed_per_day_2]
Show the field ONLY if:
[how_do_you_consume_tobacco_2] = '1'
Quantity consumed per day (average): text, Required
279 [do_you_take_tobacco_pan_du_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Do you take tobacco/pan during pregnancy? radio, Required
1Yes
2No
3Not Applicable
280 [frequency_per_day_tobaco_pre_2]
Show the field ONLY if:
[do_you_take_tobacco_pan_du_2] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
281 [other_drugs_charas_ganja_b_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Other Drugs (Charas, Ganja, Bhang, Opium, LSD, Brown Sugar, Other)(चरस; गांजा; भांग; अफ़ीम; एल.एस.डी.; ब्राउन शुगर; कोई और) descriptive
282 [who_consumes_other_drugs_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Who consumes other drugs? radio, Required
1You
2Family member
3Both
283 [do_you_consume_other_drugs_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Do you consume other drugs? yesno, Required
1Yes
0No
284 [how_do_you_consume_other_d_2]
Show the field ONLY if:
[do_you_consume_other_drugs_2] = '1'
How do you consume other drugs? radio, Required
1Regular
2Occasional
285 [what_type_of_drug_do_you_u_2]
Show the field ONLY if:
[do_you_consume_other_drugs_2] = '1'
What type of drug do you use? checkbox, Required
1what_type_of_drug_do_you_u_2___1Charas
2what_type_of_drug_do_you_u_2___2Ganja
3what_type_of_drug_do_you_u_2___3Bhang
4what_type_of_drug_do_you_u_2___4Opium
5what_type_of_drug_do_you_u_2___5LSD
6what_type_of_drug_do_you_u_2___6Brown Sugar
7what_type_of_drug_do_you_u_2___7Other (please specify)
286 [specify_other_drug_2]
Show the field ONLY if:
[what_type_of_drug_do_you_u(7)] = '1'
Specify Other text
287 [at_what_age_did_you_star_drug_2]
Show the field ONLY if:
[do_you_consume_other_drugs_2] = '1'
At what age did you start consuming drugs? text (number), Required
288 [frequency_of_drug_consumpt_2]
Show the field ONLY if:
[how_do_you_consume_other_d_2] = '1'
Frequency of drug consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
289 [quantity_consumed_per_day_drug_2]
Show the field ONLY if:
[how_do_you_consume_other_d_2] = '1'
Quantity consumed per day (average): text (number), Required
290 [do_you_take_drugs_during_p_2]
Show the field ONLY if:
[no_of_family_member] >= 2
Do you take drugs during pregnancy? radio, Required
1Yes
2No
3Not Applicable
291 [frequency_per_day_during_drug_2]
Show the field ONLY if:
[do_you_take_drugs_during_p_2] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
292 [third_family_member]
Show the field ONLY if:
[no_of_family_member] >= 3
THIRD FAMILY MEMBER descriptive
293 [sex_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Sex
लिंग 		radio, Required
1Male
2Female
3Other
294 [specify_other_3]
Show the field ONLY if:
[sex_3] = '3'
Specify other text
295 [age_year_month_days_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Age
(Year/Month/Days)
आयु
(वर्ष/महीना/दिन)
Age in years
 text (number, Min: 1, Max: 99), Required
Field Annotation: @FORCE-MINMAX
296 [relationship_with_ego_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Relationship with ego
संबंध अहंकार के साथ
 text, Required
297 [present_marital_status_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Present Marital Status
उपस्थित वैवाहिक स्थिति
 radio, Required
1Single (never married)
2Married
3Widowed
4Divorced
5Separated.
298 [educational_status_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Educational Status
शैक्षणिक स्थिति
 radio, Required
11. Primary / प्राथमिक
22. Secondary / गौण
33. And above /और ऊपर
299 [occupational_status_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Occupational Status
व्यावसायिक स्थिति
 text, Required
300 [any_kind_of_illness_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Any kind of Illness?
किसी तरह का बीमारी?

 yesno, Required
1Yes
0No
301 [name_of_illness_3]
Show the field ONLY if:
[any_kind_of_illness_3] = '1'
Name of illness text, Required
302 [duration_of_illness_3]
Show the field ONLY if:
[any_kind_of_illness_3] = '1'
Duration of illness text
303 [any_treatment_given_3]
Show the field ONLY if:
[any_kind_of_illness_3] = '1'
Any treatment Given?
कोई इलाज दिया गया?
yesno, Required
1Yes
0No
304 [if_yes_what_3]
Show the field ONLY if:
[any_treatment_given_3] = '1'
If yes, what?
अगर हाँ क्या?
 text
305 [nutritional_status_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Nutritional Status descriptive
306 [dietary_habit_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Dietary Habit
आहार संबंधी आदत 		radio, Required
1Veg / शाकाहारी
2Non-Veg / गैर-शाकाहारी
307 [amount_consumed_water_l_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Amount Consumed water (L/day):
उपभोग की गई राशि पानी (एल/दिन):
 radio, Required
1Less than 0.5 L
20.5 - 1 L
31 - 2 L
42 - 3 L
5More than 3 L
308 [no_of_full_meals_3]
Show the field ONLY if:
[no_of_family_member] >= 3
No of Full Meals:
पूर्ण भोजन की संख्या:
 radio, Required
11 meal/day
22 meals/day
33 meals/day
4More than 3 meals/day

Field Annotation: @FORCE-MINMAX
309 [frequency_non_vegetaria_3]
Show the field ONLY if:
[dietary_habit_3] = '2'
Frequency of Non-Vegetarian Food:
मांसाहारी भोजन की आवृत्ति:
 radio, Required
1Never
2Occasionally (1-2 times/month)
3Weekly (1-2 times/week)
4Frequently (3-5 times/week)
5Daily
310 [frequency_of_vegetarian_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Frequency of Vegetarian Food:
शाकाहारी भोजन की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
311 [frequency_milk_products_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Frequency of Milk Products:
दुग्ध उत्पादों की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
312 [frequency_of_pulses_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Frequency of Pulses:
दालों की आवृत्ति:
 radio, Required
1Never
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
313 [frequency_of_fruits_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Frequency of Fruits:
फलों की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
314 [any_other_specific_diet_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Any other specific diet
कोई अन्य विशिष्ट आहार
 text
315 [any_illness_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Any Illnessकोई बीमारी descriptive
316 [nutritional_deficiency_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Nutritional Deficiency
पोषण की कमी
 yesno, Required
1Yes
0No
317 [which_type_of_nutritional_3]
Show the field ONLY if:
[nutritional_deficiency_3] = '1'
Which type of Nutritional Deficiency text, Required
318 [age_at_nurition_def_3]
Show the field ONLY if:
[nutritional_deficiency_3] = '1'
Age (आयु) - At what age illness started? text (number)
319 [duration_nutrient_def_3]
Show the field ONLY if:
[nutritional_deficiency_3] = '1'
Duration (अवधि) - How long did it last? text
320 [physical_disability_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Physical Disability
शारीरिक अपंगता
 yesno, Required
1Yes
0No
321 [which_type_of_physical_dis_3]
Show the field ONLY if:
[physical_disability_3] = '1'
Which type of Physical Disability
 text, Required
322 [duration_how_long_physical_3]
Show the field ONLY if:
[physical_disability_3] = '1'
Duration (अवधि) - How long did it last? text
323 [emotional_impairment_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Emotional Impairment
भावनात्मक क्षति
 yesno, Required
1Yes
0No
324 [which_type_of_emotional_im_3]
Show the field ONLY if:
[emotional_impairment_3] = '1'
Which type of Emotional Impairment
 text, Required
325 [duration_how_long_emontiona_3]
Show the field ONLY if:
[emotional_impairment_3] = '1'
Duration (अवधि) - How long did it last? text
326 [major_therapeutic_irradiat_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Major Therapeutic Irradiation Exposure
प्रमुख चिकित्सीय विकिरण एक्सपोजर
 yesno, Required
1Yes
0No
327 [which_type_of_major_therap_3]
Show the field ONLY if:
[major_therapeutic_irradiat_3] = '1'
Which type of Major Therapeutic Irradiation Exposure
 text, Required
328 [duration_how_long_major_3]
Show the field ONLY if:
[major_therapeutic_irradiat_3] = '1'
Duration (अवधि) - How long did it last? text
329 [long_illness_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Long Illness
लंबी बीमारी
 yesno, Required
1Yes
0No
330 [which_type_of_long_illness_3]
Show the field ONLY if:
[long_illness_3] = '1'
Which type of Long Illness

 text, Required
331 [duration_how_long_ilness_3]
Show the field ONLY if:
[long_illness_3] = '1'
Duration (अवधि) - How long did it last? text
332 [g_have_you_ever_been_diagn_3]
Show the field ONLY if:
[no_of_family_member] >= 3
G. Have you ever been diagnosed by a doctor for any of the following conditions?जी. क्या आपको कभी किसी डॉक्टर द्वारा निम्नलिखित में से किसी भी स्थिति का निदान किया गया है? descriptive
333 [heart_failure_disease_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Heart failure/disease
हृदय विफलता/बीमारी
 yesno, Required
1Yes
0No
334 [type_heart_disesae_3]
Show the field ONLY if:
[heart_failure_disease_3] = '1'
Type
प्रकार 		text
335 [age_heart_faliour_3]
Show the field ONLY if:
[heart_failure_disease_3] = '1'
Age
आयु
 text (number)
336 [irritable_bowel_disease_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Irritable Bowel Disease
चिड़चिड़ा आंत्र रोग
 yesno, Required
1Yes
0No
337 [type_irritable_bowel_3]
Show the field ONLY if:
[irritable_bowel_disease_3] = '1'
Type
प्रकार
 text
338 [age_bowel_disease_3]
Show the field ONLY if:
[irritable_bowel_disease_3] = '1'
Age
आयु
 text (number)
339 [chronic_bronchitis_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Chronic Bronchitis
क्रोनिक ब्रोंकाइटिस
 yesno, Required
1Yes
0No
340 [type_bronchitis_3]
Show the field ONLY if:
[chronic_bronchitis_3] = '1'
Type
प्रकार
 text
341 [age_bronchitis_3]
Show the field ONLY if:
[chronic_bronchitis_3] = '1'
Age
आयु
 text (number)
342 [hernia_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Hernia
हरनिया
 yesno, Required
1Yes
0No
343 [type_hernia_3]
Show the field ONLY if:
[hernia_3] = '1'
Type
प्रकार
 text
344 [age_hernia_3]
Show the field ONLY if:
[hernia_3] = '1'
Age
आयु
 text (number)
345 [emphysema_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Emphysema
वातस्फीति
 yesno, Required
1Yes
0No
346 [type_endometriosis_3]
Show the field ONLY if:
[emphysema_3] = '1'
Type
प्रकार
 text
347 [age_endometriosis_3]
Show the field ONLY if:
[emphysema_3] = '1'
Age
आयु
 text (number)
348 [arthritis_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Arthritis
वात रोग
 yesno, Required
1Yes
0No
349 [type_arthritis_3]
Show the field ONLY if:
[arthritis_3] = '1'
Type
प्रकार 		text
350 [age_arthritis_3]
Show the field ONLY if:
[arthritis_3] = '1'
Age
आयु 		text (number)
351 [inflammatory_bowel_disease_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Inflammatory bowel disease
सूजा आंत्र रोग
 yesno, Required
1Yes
0No
352 [type_inflammatory_bowel_3]
Show the field ONLY if:
[inflammatory_bowel_disease_3] = '1'
Type
प्रकार 		text
353 [age_inflammatory_bowel_disease_3]
Show the field ONLY if:
[inflammatory_bowel_disease_3] = '1'
Age
आयु 		text, Required
354 [depression_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Depression
अवसाद
 yesno, Required
1Yes
0No
355 [type_depression_3]
Show the field ONLY if:
[depression_3] = '1'
Type
प्रकार 		text
356 [age_depression_3]
Show the field ONLY if:
[depression_3] = '1'
Age
आयु 		text (number)
357 [cancer_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Cancer
कैंसर
 yesno, Required
1Yes
0No
358 [type_cancer_3]
Show the field ONLY if:
[cancer_3] = '1'
Type
प्रकार 		text
359 [age_cancer_3]
Show the field ONLY if:
[cancer_3] = '1'
Age
आयु 		text (number)
360 [h_have_you_or_your_family_3]
Show the field ONLY if:
[no_of_family_member] >= 3
H. Have you or your family member suffered from any of the listed symptoms in last 1 year?क्या आप या आपके परिवार के सदस्य पिछले एक वर्ष में सूचीबद्ध लक्षणों में से किसी से पीड़ित हुए हैं? descriptive
361 [high_fever_3]
Show the field ONLY if:
[no_of_family_member] >= 3
High fever / तेज़ बुखार yesno, Required
1Yes
0No
362 [when_highg_fever_3]
Show the field ONLY if:
[high_fever_3] = "1"
When
कब 		text
363 [how_many_times_fever_3]
Show the field ONLY if:
[high_fever_3] = "1"
How many times
कितनी बार
 text
364 [weakness_and_fatigue_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Weakness and Fatigue
कमज़ोरी और थकान
 yesno, Required
1Yes
0No
365 [when_weakness_3]
Show the field ONLY if:
[weakness_and_fatigue_3] = "1"
When
कब 		text
366 [how_many_times_weakness_3]
Show the field ONLY if:
[weakness_and_fatigue_3] = "1"
How many times
कितनी बार 		text
367 [muscle_ache_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Muscle ache
मांसपेशियों में दर्द
 yesno, Required
1Yes
0No
368 [when_muscle_3]
Show the field ONLY if:
[muscle_ache_3] = "1"
When
कब 		text
369 [how_many_times_muscle_3]
Show the field ONLY if:
[muscle_ache_3] = "1"
How many times
कितनी बार 		text
370 [stomach_pain_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Stomach pain
पेट दर्द
 yesno, Required
1Yes
0No
371 [when_stomach_3]
Show the field ONLY if:
[stomach_pain_3] = "1"
When
कब 		text
372 [how_many_times_stomach_3]
Show the field ONLY if:
[stomach_pain_3] = "1"
How many times
कितनी बार 		text
373 [loss_of_appetite_and_weigh_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Loss of appetite and weight
भूख और वजन में कमी
 yesno, Required
1Yes
0No
374 [when_appetite_3]
Show the field ONLY if:
[loss_of_appetite_and_weigh_3] ="1"
When
कब 		text
375 [how_many_times_appetite_3]
Show the field ONLY if:
[loss_of_appetite_and_weigh_3] ="1"
How many times
कितनी बार 		text
376 [dry_cough_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Dry cough
सूखी खाँसी
 yesno, Required
1Yes
0No
377 [when_dry_cough_3]
Show the field ONLY if:
[dry_cough_3] = "1"
When
कब 		text
378 [how_many_times_dry_cough_3]
Show the field ONLY if:
[dry_cough_3] = "1"
How many times
कितनी बार 		text
379 [diarrhoea_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Diarrhoea
दस्त
 yesno, Required
1Yes
0No
380 [when_diarrhoea_3]
Show the field ONLY if:
[diarrhoea_3] = "1"
When
कब 		text
381 [how_many_times_diarrheaea_3]
Show the field ONLY if:
[diarrhoea_3] = "1"
How many times
कितनी बार 		text
382 [hair_fall_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Hair fall
बाल झड़ना
 yesno, Required
1Yes
0No
383 [when_hair_fall_3]
Show the field ONLY if:
[hair_fall_3] = '1'
When
कब 		text
384 [how_many_times_hair_fall_3]
Show the field ONLY if:
[hair_fall_3] = '1'
How many times
कितनी बार 		text
385 [itching_and_rashes_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Itching and rashes
खुजली और चकत्ते
 yesno, Required
1Yes
0No
386 [when_itching_3]
Show the field ONLY if:
[itching_and_rashes_3] = "1"
When
कब 		text
387 [how_many_times_itching_3]
Show the field ONLY if:
[itching_and_rashes_3] = "1"
How many times
कितनी बार 		text
388 [headaches_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Headaches
सिर दर्द
 yesno, Required
1Yes
0No
389 [when_headaches_3]
Show the field ONLY if:
[headaches_3] = "1"
When
कब 		text
390 [how_many_times_headaches_3]
Show the field ONLY if:
[headaches_3] = "1"
How many times
कितनी बार 		text
391 [eye_pain_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Eye pain
आँख का दर्द
 yesno, Required
1Yes
0No
392 [when_eye_pain_3]
Show the field ONLY if:
[eye_pain_3] = "1"
When
कब 		text
393 [how_many_times_eyepain_3]
Show the field ONLY if:
[eye_pain_3] = "1"
How many times
कितनी बार 		text
394 [alcohol_locally_fermented_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Alcohol / Locally Fermented Beer (Mahua, Whisky, Rum, Beer, Other (Mahua; Whisky; Rum; any other / महुआ; व्हिस्की; रम; कोई और) descriptive
395 [who_consumes_alcohol_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Who consumes alcohol? radio, Required
1You/ आप
2Family member/ परिवार के सदस्य
3Both / दोनों
396 [do_you_consume_alcohol_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Do you consume alcohol? yesno, Required
1Yes
0No
397 [how_do_you_consume_3]
Show the field ONLY if:
[do_you_consume_alcohol_3] = '1'
How do you consume? radio, Required
1Regular/ नियमित
2Occasional/प्रासंगिक
398 [at_what_age_did_you_start_3]
Show the field ONLY if:
[do_you_consume_alcohol_3] = '1'
At what age did you start consuming alcohol? text (number), Required
399 [frequency_of_alcohol_consu_3]
Show the field ONLY if:
[how_do_you_consume_3] = '1'
Frequency of alcohol consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
5Occasional
400 [quantity_of_alcohol_consum_3]
Show the field ONLY if:
[how_do_you_consume_3] = '1'
Quantity of alcohol consumed per day (average in ml): text (number), Required
401 [do_you_take_during_pregnan_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Do you take during pregnancy?
क्या आप गर्भावस्था के दौरान लेते हैं?
 radio, Required
1Yes
2No
3Not Applicable
402 [frequency_per_day_during_p_3]
Show the field ONLY if:
[do_you_take_during_pregnan_3] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
403 [tobacco_pan_chewing_smokin_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Tobacco / Pan (Chewing, Smoking, Beedi, Cigarette, Zarda, Other ( चबाना; धूम्रपान; प्रत्यक्ष तम्बाकू; बीड़ी; सिगरेट; ज़र्दा; कोई और ) descriptive
404 [who_consumes_tobacco_pan_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Who consumes tobacco/pan? radio, Required
1You
2Family member
3Both
405 [do_you_consume_tobacco_pan_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Do you consume tobacco/pan? yesno, Required
1Yes
0No
406 [how_do_you_consume_tobacco_3]
Show the field ONLY if:
[do_you_consume_tobacco_pan_3] = '1'
How do you consume tobacco/pan? radio, Required
1Regular
2Occasional
407 [what_form_of_tobacco_pan_d_3]
Show the field ONLY if:
[do_you_consume_tobacco_pan_3] = '1'
What form of tobacco/pan do you use? checkbox, Required
1what_form_of_tobacco_pan_d_3___1Chewing
2what_form_of_tobacco_pan_d_3___2Smoking
3what_form_of_tobacco_pan_d_3___3Beedi
4what_form_of_tobacco_pan_d_3___4Cigarette
5what_form_of_tobacco_pan_d_3___5Zarda
6what_form_of_tobacco_pan_d_3___6Other (please specify)
408 [other_specify_3]
Show the field ONLY if:
[what_form_of_tobacco_pan_d_3(6)] = '1'
Other Specify text
409 [at_what_age_did_you_tobacco_3]
Show the field ONLY if:
[do_you_consume_tobacco_pan_3] = '1'
At what age did you start consuming tobacco/pan? text (number), Required
410 [frequency_of_tobacco_pan_c_3]
Show the field ONLY if:
[how_do_you_consume_tobacco_3] = '1'
Frequency of tobacco/pan consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
411 [quantity_consumed_per_day_3]
Show the field ONLY if:
[how_do_you_consume_tobacco_3] = '1'
Quantity consumed per day (average): text, Required
412 [do_you_take_tobacco_pan_du_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Do you take tobacco/pan during pregnancy? radio, Required
1Yes
2No
3Not Applicable
413 [frequency_per_day_tobaco_pre_3]
Show the field ONLY if:
[do_you_take_tobacco_pan_du_3] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
414 [other_drugs_charas_ganja_b_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Other Drugs (Charas, Ganja, Bhang, Opium, LSD, Brown Sugar, Other)(चरस; गांजा; भांग; अफ़ीम; एल.एस.डी.; ब्राउन शुगर; कोई और) descriptive
415 [who_consumes_other_drugs_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Who consumes other drugs? radio, Required
1You
2Family member
3Both
416 [do_you_consume_other_drugs_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Do you consume other drugs? yesno, Required
1Yes
0No
417 [how_do_you_consume_other_d_3]
Show the field ONLY if:
[do_you_consume_other_drugs_3] = '1'
How do you consume other drugs? radio, Required
1Regular
2Occasional
418 [what_type_of_drug_do_you_u_3]
Show the field ONLY if:
[do_you_consume_other_drugs_3] = '1'
What type of drug do you use? checkbox, Required
1what_type_of_drug_do_you_u_3___1Charas
2what_type_of_drug_do_you_u_3___2Ganja
3what_type_of_drug_do_you_u_3___3Bhang
4what_type_of_drug_do_you_u_3___4Opium
5what_type_of_drug_do_you_u_3___5LSD
6what_type_of_drug_do_you_u_3___6Brown Sugar
7what_type_of_drug_do_you_u_3___7Other (please specify)
419 [specify_other_drug_3]
Show the field ONLY if:
[what_type_of_drug_do_you_u_3(7)] = '1'
Specify Other text
420 [at_what_age_did_you_star_drug_3]
Show the field ONLY if:
[do_you_consume_other_drugs_3] = '1'
At what age did you start consuming drugs? text (number), Required
421 [frequency_of_drug_consumpt_3]
Show the field ONLY if:
[how_do_you_consume_other_d_3] = '1'
Frequency of drug consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
422 [quantity_consumed_per_day_drug_3]
Show the field ONLY if:
[how_do_you_consume_other_d_3] = '1'
Quantity consumed per day (average): text (number), Required
423 [do_you_take_drugs_during_p_3]
Show the field ONLY if:
[no_of_family_member] >= 3
Do you take drugs during pregnancy? radio, Required
1Yes
2No
3Not Applicable
424 [frequency_per_day_during_drug_3]
Show the field ONLY if:
[do_you_take_drugs_during_p_3] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
425 [fourth_family_member]
Show the field ONLY if:
[no_of_family_member] >= 4
FOURTH FAMILY MEMBER descriptive
426 [sex_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Sex
लिंग 		radio, Required
1Male
2Female
3Other
427 [specify_other_4]
Show the field ONLY if:
[sex_4] = '3'
Specify other text
428 [age_year_month_days_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Age
(Year/Month/Days)
आयु
(वर्ष/महीना/दिन)
Age in years
 text (number, Min: 1, Max: 99), Required
Field Annotation: @FORCE-MINMAX
429 [relationship_with_ego_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Relationship with ego
संबंध अहंकार के साथ
 text, Required
430 [present_marital_status_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Present Marital Status
उपस्थित वैवाहिक स्थिति
 radio, Required
1Single (never married)
2Married
3Widowed
4Divorced
5Separated.
431 [educational_status_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Educational Status
शैक्षणिक स्थिति
 radio, Required
11. Primary / प्राथमिक
22. Secondary / गौण
33. And above /और ऊपर
432 [occupational_status_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Occupational Status
व्यावसायिक स्थिति
 text, Required
433 [any_kind_of_illness_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Any kind of Illness?
किसी तरह का बीमारी?

 yesno, Required
1Yes
0No
434 [name_of_illness_4]
Show the field ONLY if:
[any_kind_of_illness_4] = '1'
Name of illness text, Required
435 [duration_of_illness_4]
Show the field ONLY if:
[any_kind_of_illness_4] = '1'
Duration of illness text
436 [any_treatment_given_4]
Show the field ONLY if:
[any_kind_of_illness_4] = '1'
Any treatment Given?
कोई इलाज दिया गया?
yesno, Required
1Yes
0No
437 [if_yes_what_4]
Show the field ONLY if:
[any_treatment_given_4] = '1'
If yes, what?
अगर हाँ क्या?
 text
438 [nutritional_status_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Nutritional Status descriptive
439 [dietary_habit_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Dietary Habit
आहार संबंधी आदत 		radio, Required
1Veg / शाकाहारी
2Non-Veg / गैर-शाकाहारी
440 [amount_consumed_water_l_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Amount Consumed water (L/day):
उपभोग की गई राशि पानी (एल/दिन):
 radio, Required
1Less than 0.5 L
20.5 - 1 L
31 - 2 L
42 - 3 L
5More than 3 L
441 [no_of_full_meals_4]
Show the field ONLY if:
[no_of_family_member] >= 4
No of Full Meals:
पूर्ण भोजन की संख्या:
 radio, Required
11 meal/day
22 meals/day
33 meals/day
4More than 3 meals/day

Field Annotation: @FORCE-MINMAX
442 [frequency_non_vegetaria_4]
Show the field ONLY if:
[dietary_habit_4] = '2'
Frequency of Non-Vegetarian Food:
मांसाहारी भोजन की आवृत्ति:
 radio, Required
1Never
2Occasionally (1-2 times/month)
3Weekly (1-2 times/week)
4Frequently (3-5 times/week)
5Daily
443 [frequency_of_vegetarian_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Frequency of Vegetarian Food:
शाकाहारी भोजन की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
444 [frequency_milk_products_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Frequency of Milk Products:
दुग्ध उत्पादों की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
445 [frequency_of_pulses_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Frequency of Pulses:
दालों की आवृत्ति:
 radio, Required
1Never
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
446 [frequency_of_fruits_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Frequency of Fruits:
फलों की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
447 [any_other_specific_diet_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Any other specific diet
कोई अन्य विशिष्ट आहार
 text
448 [any_illness_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Any Illnessकोई बीमारी descriptive
449 [nutritional_deficiency_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Nutritional Deficiency
पोषण की कमी
 yesno, Required
1Yes
0No
450 [which_type_of_nutritional_4]
Show the field ONLY if:
[nutritional_deficiency_4] = '1'
Which type of Nutritional Deficiency text, Required
451 [age_at_nurition_def_4]
Show the field ONLY if:
[nutritional_deficiency_4] = '1'
Age (आयु) - At what age illness started? text (number)
452 [duration_nutrient_def_4]
Show the field ONLY if:
[nutritional_deficiency_4] = '1'
Duration (अवधि) - How long did it last? text
453 [physical_disability_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Physical Disability
शारीरिक अपंगता
 yesno, Required
1Yes
0No
454 [which_type_of_physical_dis_4]
Show the field ONLY if:
[physical_disability_4] = '1'
Which type of Physical Disability
 text, Required
455 [duration_how_long_physical_4]
Show the field ONLY if:
[physical_disability_4] = '1'
Duration (अवधि) - How long did it last? text
456 [emotional_impairment_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Emotional Impairment
भावनात्मक क्षति
 yesno, Required
1Yes
0No
457 [which_type_of_emotional_im_4]
Show the field ONLY if:
[emotional_impairment_4] = '1'
Which type of Emotional Impairment
 text, Required
458 [duration_how_long_emontiona_4]
Show the field ONLY if:
[emotional_impairment_4] = '1'
Duration (अवधि) - How long did it last? text
459 [major_therapeutic_irradiat_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Major Therapeutic Irradiation Exposure
प्रमुख चिकित्सीय विकिरण एक्सपोजर
 yesno, Required
1Yes
0No
460 [which_type_of_major_therap_4]
Show the field ONLY if:
[major_therapeutic_irradiat_4] = '1'
Which type of Major Therapeutic Irradiation Exposure
 text, Required
461 [duration_how_long_major_4]
Show the field ONLY if:
[major_therapeutic_irradiat_4] = '1'
Duration (अवधि) - How long did it last? text
462 [long_illness_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Long Illness
लंबी बीमारी
 yesno, Required
1Yes
0No
463 [which_type_of_long_illness_4]
Show the field ONLY if:
[long_illness_4] = '1'
Which type of Long Illness

 text, Required
464 [duration_how_long_ilness_4]
Show the field ONLY if:
[long_illness_4] = '1'
Duration (अवधि) - How long did it last? text
465 [g_have_you_ever_been_diagn_4]
Show the field ONLY if:
[no_of_family_member] >= 4
G. Have you ever been diagnosed by a doctor for any of the following conditions?जी. क्या आपको कभी किसी डॉक्टर द्वारा निम्नलिखित में से किसी भी स्थिति का निदान किया गया है? descriptive
466 [heart_failure_disease_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Heart failure/disease
हृदय विफलता/बीमारी
 yesno, Required
1Yes
0No
467 [type_heart_disesae_4]
Show the field ONLY if:
[heart_failure_disease_4] = '1'
Type
प्रकार 		text
468 [age_heart_faliour_4]
Show the field ONLY if:
[heart_failure_disease_4] = '1'
Age
आयु
 text (number)
469 [irritable_bowel_disease_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Irritable Bowel Disease
चिड़चिड़ा आंत्र रोग
 yesno, Required
1Yes
0No
470 [type_irritable_bowel_4]
Show the field ONLY if:
[irritable_bowel_disease_4] = '1'
Type
प्रकार
 text
471 [age_bowel_disease_4]
Show the field ONLY if:
[irritable_bowel_disease_4] = '1'
Age
आयु
 text (number)
472 [chronic_bronchitis_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Chronic Bronchitis
क्रोनिक ब्रोंकाइटिस
 yesno, Required
1Yes
0No
473 [type_bronchitis_4]
Show the field ONLY if:
[chronic_bronchitis_4] = '1'
Type
प्रकार
 text
474 [age_bronchitis_4]
Show the field ONLY if:
[chronic_bronchitis_4] = '1'
Age
आयु
 text (number)
475 [hernia_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Hernia
हरनिया
 yesno, Required
1Yes
0No
476 [type_hernia_4]
Show the field ONLY if:
[hernia_4] = '1'
Type
प्रकार
 text
477 [age_hernia_4]
Show the field ONLY if:
[hernia_4] = '1'
Age
आयु
 text (number)
478 [emphysema_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Emphysema
वातस्फीति
 yesno, Required
1Yes
0No
479 [type_endometriosis_4]
Show the field ONLY if:
[emphysema_4] = '1'
Type
प्रकार
 text
480 [age_endometriosis_4]
Show the field ONLY if:
[emphysema_4] = '1'
Age
आयु
 text (number)
481 [arthritis_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Arthritis
वात रोग
 yesno, Required
1Yes
0No
482 [type_arthritis_4]
Show the field ONLY if:
[arthritis_4] = '1'
Type
प्रकार 		text
483 [age_arthritis_4]
Show the field ONLY if:
[arthritis_4] = '1'
Age
आयु 		text (number)
484 [inflammatory_bowel_disease_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Inflammatory bowel disease
सूजा आंत्र रोग
 yesno, Required
1Yes
0No
485 [type_inflammatory_bowel_4]
Show the field ONLY if:
[inflammatory_bowel_disease_4] = '1'
Type
प्रकार 		text
486 [age_inflammatory_bowel_disease_4]
Show the field ONLY if:
[inflammatory_bowel_disease_4] = '1'
Age
आयु 		text, Required
487 [depression_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Depression
अवसाद
 yesno, Required
1Yes
0No
488 [type_depression_4]
Show the field ONLY if:
[depression_4] = '1'
Type
प्रकार 		text
489 [age_depression_4]
Show the field ONLY if:
[depression_4] = '1'
Age
आयु 		text (number)
490 [cancer_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Cancer
कैंसर
 yesno, Required
1Yes
0No
491 [type_cancer_4]
Show the field ONLY if:
[cancer_4] = '1'
Type
प्रकार 		text
492 [age_cancer_4]
Show the field ONLY if:
[cancer_4] = '1'
Age
आयु 		text (number)
493 [h_have_you_or_your_family_4]
Show the field ONLY if:
[no_of_family_member] >= 4
H. Have you or your family member suffered from any of the listed symptoms in last 1 year?क्या आप या आपके परिवार के सदस्य पिछले एक वर्ष में सूचीबद्ध लक्षणों में से किसी से पीड़ित हुए हैं? descriptive
494 [high_fever_4]
Show the field ONLY if:
[no_of_family_member] >= 4
High fever / तेज़ बुखार yesno, Required
1Yes
0No
495 [when_highg_fever_4]
Show the field ONLY if:
[high_fever_4] = '1'
When
कब 		text
496 [how_many_times_fever_4]
Show the field ONLY if:
[high_fever_4] = '1'
How many times
कितनी बार
 text
497 [weakness_and_fatigue_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Weakness and Fatigue
कमज़ोरी और थकान
 yesno, Required
1Yes
0No
498 [when_weakness_4]
Show the field ONLY if:
[weakness_and_fatigue_4] = "1"
When
कब 		text
499 [how_many_times_weakness_4]
Show the field ONLY if:
[weakness_and_fatigue_4] = "1"
How many times
कितनी बार 		text
500 [muscle_ache_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Muscle ache
मांसपेशियों में दर्द
 yesno, Required
1Yes
0No
501 [when_muscle_4]
Show the field ONLY if:
[muscle_ache_4] = "1"
When
कब 		text
502 [how_many_times_muscle_4]
Show the field ONLY if:
[muscle_ache_4] = "1"
How many times
कितनी बार 		text
503 [stomach_pain_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Stomach pain
पेट दर्द
 yesno, Required
1Yes
0No
504 [when_stomach_4]
Show the field ONLY if:
[stomach_pain_4] = "1"
When
कब 		text
505 [how_many_times_stomach_4]
Show the field ONLY if:
[stomach_pain_4] = "1"
How many times
कितनी बार 		text
506 [loss_of_appetite_and_weigh_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Loss of appetite and weight
भूख और वजन में कमी
 yesno, Required
1Yes
0No
507 [when_appetite_4]
Show the field ONLY if:
[loss_of_appetite_and_weigh_4] ="1"
When
कब 		text
508 [how_many_times_appetite_4]
Show the field ONLY if:
[loss_of_appetite_and_weigh_4] ="1"
How many times
कितनी बार 		text
509 [dry_cough_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Dry cough
सूखी खाँसी
 yesno, Required
1Yes
0No
510 [when_dry_cough_4]
Show the field ONLY if:
[dry_cough_4] = "1"
When
कब 		text
511 [how_many_times_dry_cough_4]
Show the field ONLY if:
[dry_cough_4] = "1"
How many times
कितनी बार 		text
512 [diarrhoea_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Diarrhoea
दस्त
 yesno, Required
1Yes
0No
513 [when_diarrhoea_4]
Show the field ONLY if:
[diarrhoea_4] = "1"
When
कब 		text
514 [how_many_times_diarrheaea_4]
Show the field ONLY if:
[diarrhoea_4] = "1"
How many times
कितनी बार 		text
515 [hair_fall_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Hair fall
बाल झड़ना
 yesno, Required
1Yes
0No
516 [when_hair_fall_4]
Show the field ONLY if:
[hair_fall_4] = '1'
When
कब 		text
517 [how_many_times_hair_fall_4]
Show the field ONLY if:
[hair_fall_4] = '1'
How many times
कितनी बार 		text
518 [itching_and_rashes_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Itching and rashes
खुजली और चकत्ते
 yesno, Required
1Yes
0No
519 [when_itching_4]
Show the field ONLY if:
[itching_and_rashes_4] = "1"
When
कब 		text
520 [how_many_times_itching_4]
Show the field ONLY if:
[itching_and_rashes_4] = "1"
How many times
कितनी बार 		text
521 [headaches_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Headaches
सिर दर्द
 yesno, Required
1Yes
0No
522 [when_headaches_4]
Show the field ONLY if:
[headaches_4] = "1"
When
कब 		text
523 [how_many_times_headaches_4]
Show the field ONLY if:
[headaches_4] = "1"
How many times
कितनी बार 		text
524 [eye_pain_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Eye pain
आँख का दर्द
 yesno, Required
1Yes
0No
525 [when_eye_pain_4]
Show the field ONLY if:
[eye_pain_4] = "1"
When
कब 		text
526 [how_many_times_eyepain_4]
Show the field ONLY if:
[eye_pain_4] = "1"
How many times
कितनी बार 		text
527 [alcohol_locally_fermented_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Alcohol / Locally Fermented Beer (Mahua, Whisky, Rum, Beer, Other (Mahua; Whisky; Rum; any other / महुआ; व्हिस्की; रम; कोई और) descriptive
528 [who_consumes_alcohol_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Who consumes alcohol? radio, Required
1You/ आप
2Family member/ परिवार के सदस्य
3Both / दोनों
529 [do_you_consume_alcohol_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Do you consume alcohol? yesno, Required
1Yes
0No
530 [how_do_you_consume_4]
Show the field ONLY if:
[do_you_consume_alcohol_4] = '1'
How do you consume? radio, Required
1Regular/ नियमित
2Occasional/प्रासंगिक
531 [at_what_age_did_you_start_4]
Show the field ONLY if:
[do_you_consume_alcohol_4] = '1'
At what age did you start consuming alcohol? text (number), Required
532 [frequency_of_alcohol_consu_4]
Show the field ONLY if:
[how_do_you_consume_4] = '1'
Frequency of alcohol consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
5Occasional
533 [quantity_of_alcohol_consum_4]
Show the field ONLY if:
[how_do_you_consume_4] = '1'
Quantity of alcohol consumed per day (average in ml): text (number), Required
534 [do_you_take_during_pregnan_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Do you take during pregnancy?
क्या आप गर्भावस्था के दौरान लेते हैं?
 radio, Required
1Yes
2No
3Not Applicable
535 [frequency_per_day_during_p_4]
Show the field ONLY if:
[do_you_take_during_pregnan_4] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
536 [tobacco_pan_chewing_smokin_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Tobacco / Pan (Chewing, Smoking, Beedi, Cigarette, Zarda, Other ( चबाना; धूम्रपान; प्रत्यक्ष तम्बाकू; बीड़ी; सिगरेट; ज़र्दा; कोई और ) descriptive
537 [who_consumes_tobacco_pan_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Who consumes tobacco/pan? radio, Required
1You
2Family member
3Both
538 [do_you_consume_tobacco_pan_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Do you consume tobacco/pan? yesno, Required
1Yes
0No
539 [how_do_you_consume_tobacco_4]
Show the field ONLY if:
[do_you_consume_tobacco_pan_4] = '1'
How do you consume tobacco/pan? radio, Required
1Regular
2Occasional
540 [what_form_of_tobacco_pan_d_4]
Show the field ONLY if:
[do_you_consume_tobacco_pan_4] = '1'
What form of tobacco/pan do you use? checkbox, Required
1what_form_of_tobacco_pan_d_4___1Chewing
2what_form_of_tobacco_pan_d_4___2Smoking
3what_form_of_tobacco_pan_d_4___3Beedi
4what_form_of_tobacco_pan_d_4___4Cigarette
5what_form_of_tobacco_pan_d_4___5Zarda
6what_form_of_tobacco_pan_d_4___6Other (please specify)
541 [other_specify_4]
Show the field ONLY if:
[what_form_of_tobacco_pan_d_4(6)] = '1'
Other Specify text
542 [at_what_age_did_you_tobacco_4]
Show the field ONLY if:
[do_you_consume_tobacco_pan_4] = '1'
At what age did you start consuming tobacco/pan? text (number), Required
543 [frequency_of_tobacco_pan_c_4]
Show the field ONLY if:
[how_do_you_consume_tobacco_4] = '1'
Frequency of tobacco/pan consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
544 [quantity_consumed_per_day_4]
Show the field ONLY if:
[how_do_you_consume_tobacco_4] = '1'
Quantity consumed per day (average): text, Required
545 [do_you_take_tobacco_pan_du_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Do you take tobacco/pan during pregnancy? radio, Required
1Yes
2No
3Not Applicable
546 [frequency_per_day_tobaco_pre_4]
Show the field ONLY if:
[do_you_take_tobacco_pan_du_4] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
547 [other_drugs_charas_ganja_b_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Other Drugs (Charas, Ganja, Bhang, Opium, LSD, Brown Sugar, Other)(चरस; गांजा; भांग; अफ़ीम; एल.एस.डी.; ब्राउन शुगर; कोई और) descriptive
548 [who_consumes_other_drugs_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Who consumes other drugs? radio, Required
1You
2Family member
3Both
549 [do_you_consume_other_drugs_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Do you consume other drugs? yesno, Required
1Yes
0No
550 [how_do_you_consume_other_d_4]
Show the field ONLY if:
[do_you_consume_other_drugs_4] = '1'
How do you consume other drugs? radio, Required
1Regular
2Occasional
551 [what_type_of_drug_do_you_u_4]
Show the field ONLY if:
[do_you_consume_other_drugs_4] = '1'
What type of drug do you use? checkbox, Required
1what_type_of_drug_do_you_u_4___1Charas
2what_type_of_drug_do_you_u_4___2Ganja
3what_type_of_drug_do_you_u_4___3Bhang
4what_type_of_drug_do_you_u_4___4Opium
5what_type_of_drug_do_you_u_4___5LSD
6what_type_of_drug_do_you_u_4___6Brown Sugar
7what_type_of_drug_do_you_u_4___7Other (please specify)
552 [specify_other_drug_4]
Show the field ONLY if:
[what_type_of_drug_do_you_u_4(7)] = '1'
Specify Other text
553 [at_what_age_did_you_star_drug_4]
Show the field ONLY if:
[do_you_consume_other_drugs_4] = '1'
At what age did you start consuming drugs? text (number), Required
554 [frequency_of_drug_consumpt_4]
Show the field ONLY if:
[how_do_you_consume_other_d_4] = '1'
Frequency of drug consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
555 [quantity_consumed_per_day_drug_4]
Show the field ONLY if:
[how_do_you_consume_other_d_4] = '1'
Quantity consumed per day (average): text (number), Required
556 [do_you_take_drugs_during_p_4]
Show the field ONLY if:
[no_of_family_member] >= 4
Do you take drugs during pregnancy? radio, Required
1Yes
2No
3Not Applicable
557 [frequency_per_day_during_drug_4]
Show the field ONLY if:
[do_you_take_drugs_during_p_4] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
558 [fifth_family_member]
Show the field ONLY if:
[no_of_family_member] >= 5
FIFTH FAMILY MEMBER descriptive
559 [sex_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Sex
लिंग 		radio, Required
1Male
2Female
3Other
560 [specify_other_5]
Show the field ONLY if:
[sex_5] = '3'
Specify other text
561 [age_year_month_days_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Age
(Year/Month/Days)
आयु
(वर्ष/महीना/दिन)
Age in years
 text (number, Min: 1, Max: 99), Required
Field Annotation: @FORCE-MINMAX
562 [relationship_with_ego_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Relationship with ego
संबंध अहंकार के साथ
 text, Required
563 [present_marital_status_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Present Marital Status
उपस्थित वैवाहिक स्थिति
 radio, Required
1Single (never married)
2Married
3Widowed
4Divorced
5Separated.
564 [educational_status_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Educational Status
शैक्षणिक स्थिति
 radio, Required
11. Primary / प्राथमिक
22. Secondary / गौण
33. And above /और ऊपर
565 [occupational_status_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Occupational Status
व्यावसायिक स्थिति
 text, Required
566 [any_kind_of_illness_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Any kind of Illness?
किसी तरह का बीमारी?

 yesno, Required
1Yes
0No
567 [name_of_illness_5]
Show the field ONLY if:
[any_kind_of_illness_5] = '1'
Name of illness text, Required
568 [duration_of_illness_5]
Show the field ONLY if:
[any_kind_of_illness_5] = '1'
Duration of illness text
569 [any_treatment_given_5]
Show the field ONLY if:
[any_kind_of_illness_5] = '1'
Any treatment Given?
कोई इलाज दिया गया?
yesno, Required
1Yes
0No
570 [if_yes_what_5]
Show the field ONLY if:
[any_treatment_given_5] = '1'
If yes, what?
अगर हाँ क्या?
 text
571 [nutritional_status_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Nutritional Status descriptive
572 [dietary_habit_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Dietary Habit
आहार संबंधी आदत 		radio, Required
1Veg / शाकाहारी
2Non-Veg / गैर-शाकाहारी
573 [amount_consumed_water_l_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Amount Consumed water (L/day):
उपभोग की गई राशि पानी (एल/दिन):
 radio, Required
1Less than 0.5 L
20.5 - 1 L
31 - 2 L
42 - 3 L
5More than 3 L
574 [no_of_full_meals_5]
Show the field ONLY if:
[no_of_family_member] >= 5
No of Full Meals:
पूर्ण भोजन की संख्या:
 radio, Required
11 meal/day
22 meals/day
33 meals/day
4More than 3 meals/day

Field Annotation: @FORCE-MINMAX
575 [frequency_non_vegetaria_5]
Show the field ONLY if:
[dietary_habit_5] = '2'
Frequency of Non-Vegetarian Food:
मांसाहारी भोजन की आवृत्ति:
 radio, Required
1Never
2Occasionally (1-2 times/month)
3Weekly (1-2 times/week)
4Frequently (3-5 times/week)
5Daily
576 [frequency_of_vegetarian_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Frequency of Vegetarian Food:
शाकाहारी भोजन की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
577 [frequency_milk_products_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Frequency of Milk Products:
दुग्ध उत्पादों की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
578 [frequency_of_pulses_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Frequency of Pulses:
दालों की आवृत्ति:
 radio, Required
1Never
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
579 [frequency_of_fruits_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Frequency of Fruits:
फलों की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
580 [any_other_specific_diet_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Any other specific diet
कोई अन्य विशिष्ट आहार
 text
581 [any_illness_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Any Illnessकोई बीमारी descriptive
582 [nutritional_deficiency_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Nutritional Deficiency
पोषण की कमी
 yesno, Required
1Yes
0No
583 [which_type_of_nutritional_5]
Show the field ONLY if:
[nutritional_deficiency_5] = '1'
Which type of Nutritional Deficiency text, Required
584 [age_at_nurition_def_5]
Show the field ONLY if:
[nutritional_deficiency_5] = '1'
Age (आयु) - At what age illness started? text (number)
585 [duration_nutrient_def_5]
Show the field ONLY if:
[nutritional_deficiency_5] = '1'
Duration (अवधि) - How long did it last? text
586 [physical_disability_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Physical Disability
शारीरिक अपंगता
 yesno, Required
1Yes
0No
587 [which_type_of_physical_dis_5]
Show the field ONLY if:
[physical_disability_5] = '1'
Which type of Physical Disability
 text, Required
588 [duration_how_long_physical_5]
Show the field ONLY if:
[physical_disability_5] = '1'
Duration (अवधि) - How long did it last? text
589 [emotional_impairment_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Emotional Impairment
भावनात्मक क्षति
 yesno, Required
1Yes
0No
590 [which_type_of_emotional_im_5]
Show the field ONLY if:
[emotional_impairment_5] = '1'
Which type of Emotional Impairment
 text, Required
591 [duration_how_long_emontiona_5]
Show the field ONLY if:
[emotional_impairment_5] = '1'
Duration (अवधि) - How long did it last? text
592 [major_therapeutic_irradiat_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Major Therapeutic Irradiation Exposure
प्रमुख चिकित्सीय विकिरण एक्सपोजर
 yesno, Required
1Yes
0No
593 [which_type_of_major_therap_5]
Show the field ONLY if:
[major_therapeutic_irradiat_5] = '1'
Which type of Major Therapeutic Irradiation Exposure
 text, Required
594 [duration_how_long_major_5]
Show the field ONLY if:
[major_therapeutic_irradiat_5] = '1'
Duration (अवधि) - How long did it last? text
595 [long_illness_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Long Illness
लंबी बीमारी
 yesno, Required
1Yes
0No
596 [which_type_of_long_illness_5]
Show the field ONLY if:
[long_illness_5] = '1'
Which type of Long Illness

 text, Required
597 [duration_how_long_ilness_5]
Show the field ONLY if:
[long_illness_5] = '1'
Duration (अवधि) - How long did it last? text
598 [g_have_you_ever_been_diagn_5]
Show the field ONLY if:
[no_of_family_member] >= 5
G. Have you ever been diagnosed by a doctor for any of the following conditions?जी. क्या आपको कभी किसी डॉक्टर द्वारा निम्नलिखित में से किसी भी स्थिति का निदान किया गया है? descriptive
599 [heart_failure_disease_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Heart failure/disease
हृदय विफलता/बीमारी
 yesno, Required
1Yes
0No
600 [type_heart_disesae_5]
Show the field ONLY if:
[heart_failure_disease_5] = '1'
Type
प्रकार 		text
601 [age_heart_faliour_5]
Show the field ONLY if:
[heart_failure_disease_5] = '1'
Age
आयु
 text (number)
602 [irritable_bowel_disease_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Irritable Bowel Disease
चिड़चिड़ा आंत्र रोग
 yesno, Required
1Yes
0No
603 [type_irritable_bowel_5]
Show the field ONLY if:
[irritable_bowel_disease_5] = '1'
Type
प्रकार
 text
604 [age_bowel_disease_5]
Show the field ONLY if:
[irritable_bowel_disease_5] = '1'
Age
आयु
 text (number)
605 [chronic_bronchitis_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Chronic Bronchitis
क्रोनिक ब्रोंकाइटिस
 yesno, Required
1Yes
0No
606 [type_bronchitis_5]
Show the field ONLY if:
[chronic_bronchitis_5] = '1'
Type
प्रकार
 text
607 [age_bronchitis_5]
Show the field ONLY if:
[chronic_bronchitis_5] = '1'
Age
आयु
 text (number)
608 [hernia_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Hernia
हरनिया
 yesno, Required
1Yes
0No
609 [type_hernia_5]
Show the field ONLY if:
[hernia_5] = '1'
Type
प्रकार
 text
610 [age_hernia_5]
Show the field ONLY if:
[hernia_5] = '1'
Age
आयु
 text (number)
611 [emphysema_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Emphysema
वातस्फीति
 yesno, Required
1Yes
0No
612 [type_endometriosis_5]
Show the field ONLY if:
[emphysema_5] = '1'
Type
प्रकार
 text
613 [age_endometriosis_5]
Show the field ONLY if:
[emphysema_5] = '1'
Age
आयु
 text (number)
614 [arthritis_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Arthritis
वात रोग
 yesno, Required
1Yes
0No
615 [type_arthritis_5]
Show the field ONLY if:
[arthritis_5] = '1'
Type
प्रकार 		text
616 [age_arthritis_5]
Show the field ONLY if:
[arthritis_5] = '1'
Age
आयु 		text (number)
617 [inflammatory_bowel_disease_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Inflammatory bowel disease
सूजा आंत्र रोग
 yesno, Required
1Yes
0No
618 [type_inflammatory_bowel_5]
Show the field ONLY if:
[inflammatory_bowel_disease_5] = '1'
Type
प्रकार 		text
619 [depression_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Depression
अवसाद
 yesno, Required
1Yes
0No
620 [type_depression_5]
Show the field ONLY if:
[depression_5] = '1'
Type
प्रकार 		text
621 [age_depression_5]
Show the field ONLY if:
[depression_5] = '1'
Age
आयु 		text (number)
622 [cancer_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Cancer
कैंसर
 yesno, Required
1Yes
0No
623 [type_cancer_5]
Show the field ONLY if:
[cancer_5] = '1'
Type
प्रकार 		text
624 [age_cancer_5]
Show the field ONLY if:
[cancer_5] = '1'
Age
आयु 		text (number)
625 [h_have_you_or_your_family_5]
Show the field ONLY if:
[no_of_family_member] >= 5
H. Have you or your family member suffered from any of the listed symptoms in last 1 year?क्या आप या आपके परिवार के सदस्य पिछले एक वर्ष में सूचीबद्ध लक्षणों में से किसी से पीड़ित हुए हैं? descriptive
626 [high_fever_5]
Show the field ONLY if:
[no_of_family_member] >= 5
High fever / तेज़ बुखार yesno, Required
1Yes
0No
627 [when_highg_fever_5]
Show the field ONLY if:
[high_fever_5] = '1'
When
कब 		text
628 [how_many_times_fever_5]
Show the field ONLY if:
[high_fever_5] = '1'
How many times
कितनी बार
 text
629 [weakness_and_fatigue_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Weakness and Fatigue
कमज़ोरी और थकान
 yesno, Required
1Yes
0No
630 [when_weakness_5]
Show the field ONLY if:
[weakness_and_fatigue_5] = "1"
When
कब 		text
631 [how_many_times_weakness_5]
Show the field ONLY if:
[weakness_and_fatigue_5] = "1"
How many times
कितनी बार 		text
632 [muscle_ache_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Muscle ache
मांसपेशियों में दर्द
 yesno, Required
1Yes
0No
633 [when_muscle_5]
Show the field ONLY if:
[muscle_ache_5] = "1"
When
कब 		text
634 [how_many_times_muscle_5]
Show the field ONLY if:
[muscle_ache_5] = "1"
How many times
कितनी बार 		text
635 [stomach_pain_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Stomach pain
पेट दर्द
 yesno, Required
1Yes
0No
636 [when_stomach_5]
Show the field ONLY if:
[stomach_pain_5] = "1"
When
कब 		text
637 [how_many_times_stomach_5]
Show the field ONLY if:
[stomach_pain_5] = "1"
How many times
कितनी बार 		text
638 [loss_of_appetite_and_weigh_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Loss of appetite and weight
भूख और वजन में कमी
 yesno, Required
1Yes
0No
639 [when_appetite_5]
Show the field ONLY if:
[loss_of_appetite_and_weigh_5] ="1"
When
कब 		text
640 [how_many_times_appetite_5]
Show the field ONLY if:
[loss_of_appetite_and_weigh_5] ="1"
How many times
कितनी बार 		text
641 [dry_cough_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Dry cough
सूखी खाँसी
 yesno, Required
1Yes
0No
642 [when_dry_cough_5]
Show the field ONLY if:
[dry_cough_5] = "1"
When
कब 		text
643 [how_many_times_dry_cough_5]
Show the field ONLY if:
[dry_cough_5] = "1"
How many times
कितनी बार 		text
644 [diarrhoea_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Diarrhoea
दस्त
 yesno, Required
1Yes
0No
645 [when_diarrhoea_5]
Show the field ONLY if:
[diarrhoea_5] = "1"
When
कब 		text
646 [how_many_times_diarrheaea_5]
Show the field ONLY if:
[diarrhoea_5] = "1"
How many times
कितनी बार 		text
647 [hair_fall_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Hair fall
बाल झड़ना
 yesno, Required
1Yes
0No
648 [when_hair_fall_5]
Show the field ONLY if:
[hair_fall_5] = '1'
When
कब 		text
649 [how_many_times_hair_fall_5]
Show the field ONLY if:
[hair_fall_5] = '1'
How many times
कितनी बार 		text
650 [itching_and_rashes_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Itching and rashes
खुजली और चकत्ते
 yesno, Required
1Yes
0No
651 [when_itching_5]
Show the field ONLY if:
[itching_and_rashes_5] = "1"
When
कब 		text
652 [how_many_times_itching_5]
Show the field ONLY if:
[itching_and_rashes_5] = "1"
How many times
कितनी बार 		text
653 [headaches_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Headaches
सिर दर्द
 yesno, Required
1Yes
0No
654 [when_headaches_5]
Show the field ONLY if:
[headaches_5] = "1"
When
कब 		text
655 [how_many_times_headaches_5]
Show the field ONLY if:
[headaches_5] = "1"
How many times
कितनी बार 		text
656 [eye_pain_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Eye pain
आँख का दर्द
 yesno, Required
1Yes
0No
657 [when_eye_pain_5]
Show the field ONLY if:
[eye_pain_5] = "1"
When
कब 		text
658 [how_many_times_eyepain_5]
Show the field ONLY if:
[eye_pain_5] = "1"
How many times
कितनी बार 		text
659 [alcohol_locally_fermented_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Alcohol / Locally Fermented Beer (Mahua, Whisky, Rum, Beer, Other (Mahua; Whisky; Rum; any other / महुआ; व्हिस्की; रम; कोई और) descriptive
660 [who_consumes_alcohol_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Who consumes alcohol? radio, Required
1You/ आप
2Family member/ परिवार के सदस्य
3Both / दोनों
661 [do_you_consume_alcohol_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Do you consume alcohol? yesno, Required
1Yes
0No
662 [how_do_you_consume_5]
Show the field ONLY if:
[do_you_consume_alcohol_5] = '1'
How do you consume? radio, Required
1Regular/ नियमित
2Occasional/प्रासंगिक
663 [at_what_age_did_you_start_5]
Show the field ONLY if:
[do_you_consume_alcohol_5] = '1'
At what age did you start consuming alcohol? text (number), Required
664 [frequency_of_alcohol_consu_5]
Show the field ONLY if:
[how_do_you_consume_5] = '1'
Frequency of alcohol consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
5Occasional
665 [quantity_of_alcohol_consum_5]
Show the field ONLY if:
[how_do_you_consume_5] = '1'
Quantity of alcohol consumed per day (average in ml): text (number), Required
666 [do_you_take_during_pregnan_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Do you take during pregnancy?
क्या आप गर्भावस्था के दौरान लेते हैं?
 radio, Required
1Yes
2No
3Not Applicable
667 [frequency_per_day_during_p_5]
Show the field ONLY if:
[do_you_take_during_pregnan_5] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
668 [tobacco_pan_chewing_smokin_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Tobacco / Pan (Chewing, Smoking, Beedi, Cigarette, Zarda, Other ( चबाना; धूम्रपान; प्रत्यक्ष तम्बाकू; बीड़ी; सिगरेट; ज़र्दा; कोई और ) descriptive
669 [who_consumes_tobacco_pan_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Who consumes tobacco/pan? radio, Required
1You
2Family member
3Both
670 [do_you_consume_tobacco_pan_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Do you consume tobacco/pan? yesno, Required
1Yes
0No
671 [how_do_you_consume_tobacco_5]
Show the field ONLY if:
[do_you_consume_tobacco_pan_5] = '1'
How do you consume tobacco/pan? radio, Required
1Regular
2Occasional
672 [what_form_of_tobacco_pan_d_5]
Show the field ONLY if:
[do_you_consume_tobacco_pan_5] = '1'
What form of tobacco/pan do you use? checkbox, Required
1what_form_of_tobacco_pan_d_5___1Chewing
2what_form_of_tobacco_pan_d_5___2Smoking
3what_form_of_tobacco_pan_d_5___3Beedi
4what_form_of_tobacco_pan_d_5___4Cigarette
5what_form_of_tobacco_pan_d_5___5Zarda
6what_form_of_tobacco_pan_d_5___6Other (please specify)
673 [other_specify_5]
Show the field ONLY if:
[what_form_of_tobacco_pan_d_5(6)] = '1'
Other Specify text
674 [at_what_age_did_you_tobacco_5]
Show the field ONLY if:
[do_you_consume_tobacco_pan_5] = '1'
At what age did you start consuming tobacco/pan? text (number), Required
675 [frequency_of_tobacco_pan_c_5]
Show the field ONLY if:
[how_do_you_consume_tobacco_5] = '1'
Frequency of tobacco/pan consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
676 [quantity_consumed_per_day_5]
Show the field ONLY if:
[how_do_you_consume_tobacco_5] = '1'
Quantity consumed per day (average): text, Required
677 [do_you_take_tobacco_pan_du_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Do you take tobacco/pan during pregnancy? radio, Required
1Yes
2No
3Not Applicable
678 [frequency_per_day_tobaco_pre_5]
Show the field ONLY if:
[do_you_take_tobacco_pan_du_5] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
679 [other_drugs_charas_ganja_b_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Other Drugs (Charas, Ganja, Bhang, Opium, LSD, Brown Sugar, Other)(चरस; गांजा; भांग; अफ़ीम; एल.एस.डी.; ब्राउन शुगर; कोई और) descriptive
680 [who_consumes_other_drugs_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Who consumes other drugs? radio, Required
1You
2Family member
3Both
681 [do_you_consume_other_drugs_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Do you consume other drugs? yesno, Required
1Yes
0No
682 [how_do_you_consume_other_d_5]
Show the field ONLY if:
[do_you_consume_other_drugs_5] = '1'
How do you consume other drugs? radio, Required
1Regular
2Occasional
683 [what_type_of_drug_do_you_u_5]
Show the field ONLY if:
[do_you_consume_other_drugs_5] = '1'
What type of drug do you use? checkbox, Required
1what_type_of_drug_do_you_u_5___1Charas
2what_type_of_drug_do_you_u_5___2Ganja
3what_type_of_drug_do_you_u_5___3Bhang
4what_type_of_drug_do_you_u_5___4Opium
5what_type_of_drug_do_you_u_5___5LSD
6what_type_of_drug_do_you_u_5___6Brown Sugar
7what_type_of_drug_do_you_u_5___7Other (please specify)
684 [specify_other_drug_5]
Show the field ONLY if:
[what_type_of_drug_do_you_u_5(7)] = '1'
Specify Other text
685 [at_what_age_did_you_star_drug_5]
Show the field ONLY if:
[do_you_consume_other_drugs_5] = '1'
At what age did you start consuming drugs? text (number), Required
686 [frequency_of_drug_consumpt_5]
Show the field ONLY if:
[how_do_you_consume_other_d_5] = '1'
Frequency of drug consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
687 [quantity_consumed_per_day_drug_5]
Show the field ONLY if:
[how_do_you_consume_other_d_5] = '1'
Quantity consumed per day (average): text (number), Required
688 [do_you_take_drugs_during_p_5]
Show the field ONLY if:
[no_of_family_member] >= 5
Do you take drugs during pregnancy? radio, Required
1Yes
2No
3Not Applicable
689 [frequency_per_day_during_drug_5]
Show the field ONLY if:
[do_you_take_drugs_during_p_5] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
690 [sixth_family_member]
Show the field ONLY if:
[no_of_family_member] >= 6
SIXTH FAMILY MEMBER descriptive
691 [sex_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Sex
लिंग 		radio, Required
1Male
2Female
3Other
692 [specify_other_6]
Show the field ONLY if:
[sex_6] = '3'
Specify other text
693 [age_year_month_days_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Age
(Year/Month/Days)
आयु
(वर्ष/महीना/दिन)
Age in years
 text (number, Min: 1, Max: 99), Required
Field Annotation: @FORCE-MINMAX
694 [relationship_with_ego_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Relationship with ego
संबंध अहंकार के साथ
 text, Required
695 [present_marital_status_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Present Marital Status
उपस्थित वैवाहिक स्थिति
 radio, Required
1Single (never married)
2Married
3Widowed
4Divorced
5Separated.
696 [educational_status_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Educational Status
शैक्षणिक स्थिति
 radio, Required
11. Primary / प्राथमिक
22. Secondary / गौण
33. And above /और ऊपर
697 [occupational_status_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Occupational Status
व्यावसायिक स्थिति
 text, Required
698 [any_kind_of_illness_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Any kind of Illness?
किसी तरह का बीमारी?

 yesno, Required
1Yes
0No
699 [name_of_illness_6]
Show the field ONLY if:
[any_kind_of_illness_6] = '1'
Name of illness text, Required
700 [duration_of_illness_6]
Show the field ONLY if:
[any_kind_of_illness_6] = '1'
Duration of illness text
701 [any_treatment_given_6]
Show the field ONLY if:
[any_kind_of_illness_6] = '1'
Any treatment Given?
कोई इलाज दिया गया?
yesno, Required
1Yes
0No
702 [if_yes_what_6]
Show the field ONLY if:
[any_treatment_given_6] = '1'
If yes, what?
अगर हाँ क्या?
 text
703 [nutritional_status_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Nutritional Status descriptive
704 [dietary_habit_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Dietary Habit
आहार संबंधी आदत 		radio, Required
1Veg / शाकाहारी
2Non-Veg / गैर-शाकाहारी
705 [amount_consumed_water_l_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Amount Consumed water (L/day):
उपभोग की गई राशि पानी (एल/दिन):
 radio, Required
1Less than 0.5 L
20.5 - 1 L
31 - 2 L
42 - 3 L
5More than 3 L
706 [no_of_full_meals_6]
Show the field ONLY if:
[no_of_family_member] >= 6
No of Full Meals:
पूर्ण भोजन की संख्या:
 radio, Required
11 meal/day
22 meals/day
33 meals/day
4More than 3 meals/day

Field Annotation: @FORCE-MINMAX
707 [frequency_non_vegetaria_6]
Show the field ONLY if:
[dietary_habit_6] = '2'
Frequency of Non-Vegetarian Food:
मांसाहारी भोजन की आवृत्ति:
 radio, Required
1Never
2Occasionally (1-2 times/month)
3Weekly (1-2 times/week)
4Frequently (3-5 times/week)
5Daily
708 [frequency_of_vegetarian_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Frequency of Vegetarian Food:
शाकाहारी भोजन की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
709 [frequency_milk_products_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Frequency of Milk Products:
दुग्ध उत्पादों की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
710 [frequency_of_pulses_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Frequency of Pulses:
दालों की आवृत्ति:
 radio, Required
1Never
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
711 [frequency_of_fruits_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Frequency of Fruits:
फलों की आवृत्ति:
 radio, Required
1Rarely (less than 1 time/week)
2Occasionally (1-2 times/week)
3Frequently (3-5 times/week)
4Daily
712 [any_other_specific_diet_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Any other specific diet
कोई अन्य विशिष्ट आहार
 text
713 [any_illness_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Any Illnessकोई बीमारी descriptive
714 [nutritional_deficiency_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Nutritional Deficiency
पोषण की कमी
 yesno, Required
1Yes
0No
715 [which_type_of_nutritional_6]
Show the field ONLY if:
[nutritional_deficiency_6] = '1'
Which type of Nutritional Deficiency text, Required
716 [age_at_nurition_def_6]
Show the field ONLY if:
[nutritional_deficiency_6] = '1'
Age (आयु) - At what age illness started? text (number)
717 [duration_nutrient_def_6]
Show the field ONLY if:
[nutritional_deficiency_6] = '1'
Duration (अवधि) - How long did it last? text
718 [physical_disability_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Physical Disability
शारीरिक अपंगता
 yesno, Required
1Yes
0No
719 [which_type_of_physical_dis_6]
Show the field ONLY if:
[physical_disability_6] = '1'
Which type of Physical Disability
 text, Required
720 [duration_how_long_physical_6]
Show the field ONLY if:
[physical_disability_6] = '1'
Duration (अवधि) - How long did it last? text
721 [emotional_impairment_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Emotional Impairment
भावनात्मक क्षति
 yesno, Required
1Yes
0No
722 [which_type_of_emotional_im_6]
Show the field ONLY if:
[emotional_impairment_6] = '1'
Which type of Emotional Impairment
 text, Required
723 [duration_how_long_emontiona_6]
Show the field ONLY if:
[emotional_impairment_6] = '1'
Duration (अवधि) - How long did it last? text
724 [major_therapeutic_irradiat_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Major Therapeutic Irradiation Exposure
प्रमुख चिकित्सीय विकिरण एक्सपोजर
 yesno, Required
1Yes
0No
725 [which_type_of_major_therap_6]
Show the field ONLY if:
[major_therapeutic_irradiat_6] = '1'
Which type of Major Therapeutic Irradiation Exposure
 text, Required
726 [duration_how_long_major_6]
Show the field ONLY if:
[major_therapeutic_irradiat_6] = '1'
Duration (अवधि) - How long did it last? text
727 [long_illness_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Long Illness
लंबी बीमारी
 yesno, Required
1Yes
0No
728 [which_type_of_long_illness_6]
Show the field ONLY if:
[long_illness_6] = '1'
Which type of Long Illness

 text, Required
729 [duration_how_long_ilness_6]
Show the field ONLY if:
[long_illness_6] = '1'
Duration (अवधि) - How long did it last? text
730 [g_have_you_ever_been_diagn_6]
Show the field ONLY if:
[no_of_family_member] >= 6
G. Have you ever been diagnosed by a doctor for any of the following conditions?जी. क्या आपको कभी किसी डॉक्टर द्वारा निम्नलिखित में से किसी भी स्थिति का निदान किया गया है? descriptive
731 [heart_failure_disease_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Heart failure/disease
हृदय विफलता/बीमारी
 yesno, Required
1Yes
0No
732 [type_heart_disesae_6]
Show the field ONLY if:
[heart_failure_disease_6] = '1'
Type
प्रकार 		text
733 [age_heart_faliour_6]
Show the field ONLY if:
[heart_failure_disease_6] = '1'
Age
आयु
 text (number)
734 [irritable_bowel_disease_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Irritable Bowel Disease
चिड़चिड़ा आंत्र रोग
 yesno, Required
1Yes
0No
735 [type_irritable_bowel_6]
Show the field ONLY if:
[irritable_bowel_disease_6] = '1'
Type
प्रकार
 text
736 [age_bowel_disease_6]
Show the field ONLY if:
[irritable_bowel_disease_6] = '1'
Age
आयु
 text (number)
737 [chronic_bronchitis_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Chronic Bronchitis
क्रोनिक ब्रोंकाइटिस
 yesno, Required
1Yes
0No
738 [type_bronchitis_6]
Show the field ONLY if:
[chronic_bronchitis_6] = '1'
Type
प्रकार
 text
739 [age_bronchitis_6]
Show the field ONLY if:
[chronic_bronchitis_6] = '1'
Age
आयु
 text (number)
740 [hernia_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Hernia
हरनिया
 yesno, Required
1Yes
0No
741 [type_hernia_6]
Show the field ONLY if:
[hernia_6] = '1'
Type
प्रकार
 text
742 [age_hernia_6]
Show the field ONLY if:
[hernia_6] = '1'
Age
आयु
 text (number)
743 [emphysema_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Emphysema
वातस्फीति
 yesno, Required
1Yes
0No
744 [type_endometriosis_6]
Show the field ONLY if:
[emphysema_6] = '1'
Type
प्रकार
 text
745 [age_endometriosis_6]
Show the field ONLY if:
[emphysema_6] = '1'
Age
आयु
 text (number)
746 [arthritis_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Arthritis
वात रोग
 yesno, Required
1Yes
0No
747 [type_arthritis_6]
Show the field ONLY if:
[arthritis_6] = '1'
Type
प्रकार 		text
748 [age_arthritis_6]
Show the field ONLY if:
[arthritis_6] = '1'
Age
आयु 		text (number)
749 [inflammatory_bowel_disease_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Inflammatory bowel disease
सूजा आंत्र रोग
 yesno, Required
1Yes
0No
750 [type_inflammatory_bowel_6]
Show the field ONLY if:
[inflammatory_bowel_disease_6] = '1'
Type
प्रकार 		text
751 [age_imflamatry_bowel_6]
Show the field ONLY if:
[inflammatory_bowel_disease_6] = '1'
Age
आयु 		text (number)
752 [depression_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Depression
अवसाद
 yesno, Required
1Yes
0No
753 [type_depression_6]
Show the field ONLY if:
[depression_6] = '1'
Type
प्रकार 		text
754 [age_depression_6]
Show the field ONLY if:
[depression_6] = '1'
Age
आयु 		text (number)
755 [cancer_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Cancer
कैंसर
 yesno, Required
1Yes
0No
756 [type_cancer_6]
Show the field ONLY if:
[cancer_6] = '1'
Type
प्रकार 		text
757 [age_cancer_6]
Show the field ONLY if:
[cancer_6] = '1'
Age
आयु 		text (number)
758 [h_have_you_or_your_family_6]
Show the field ONLY if:
[no_of_family_member] >= 6
H. Have you or your family member suffered from any of the listed symptoms in last 1 year?क्या आप या आपके परिवार के सदस्य पिछले एक वर्ष में सूचीबद्ध लक्षणों में से किसी से पीड़ित हुए हैं? descriptive
759 [high_fever_6]
Show the field ONLY if:
[no_of_family_member] >= 6
High fever / तेज़ बुखार yesno, Required
1Yes
0No
760 [when_highg_fever_6]
Show the field ONLY if:
[high_fever_6] = '1'
When
कब 		text
761 [how_many_times_fever_6]
Show the field ONLY if:
[high_fever_6] = '1'
How many times
कितनी बार
 text
762 [weakness_and_fatigue_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Weakness and Fatigue
कमज़ोरी और थकान
 yesno, Required
1Yes
0No
763 [when_weakness_6]
Show the field ONLY if:
[weakness_and_fatigue_6] = "1"
When
कब 		text
764 [how_many_times_weakness_6]
Show the field ONLY if:
[weakness_and_fatigue_6] = "1"
How many times
कितनी बार 		text
765 [muscle_ache_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Muscle ache
मांसपेशियों में दर्द
 yesno, Required
1Yes
0No
766 [when_muscle_6]
Show the field ONLY if:
[muscle_ache_6] = "1"
When
कब 		text
767 [how_many_times_muscle_6]
Show the field ONLY if:
[muscle_ache_6] = "1"
How many times
कितनी बार 		text
768 [stomach_pain_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Stomach pain
पेट दर्द
 yesno, Required
1Yes
0No
769 [when_stomach_6]
Show the field ONLY if:
[stomach_pain_6] = "1"
When
कब 		text
770 [how_many_times_stomach_6]
Show the field ONLY if:
[stomach_pain_6] = "1"
How many times
कितनी बार 		text
771 [loss_of_appetite_and_weigh_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Loss of appetite and weight
भूख और वजन में कमी
 yesno, Required
1Yes
0No
772 [when_appetite_6]
Show the field ONLY if:
[loss_of_appetite_and_weigh_6] ="1"
When
कब 		text
773 [how_many_times_appetite_6]
Show the field ONLY if:
[loss_of_appetite_and_weigh_6] ="1"
How many times
कितनी बार 		text
774 [dry_cough_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Dry cough
सूखी खाँसी
 yesno, Required
1Yes
0No
775 [when_dry_cough_6]
Show the field ONLY if:
[dry_cough_6] = "1"
When
कब 		text
776 [how_many_times_dry_cough_6]
Show the field ONLY if:
[dry_cough_6] = "1"
How many times
कितनी बार 		text
777 [diarrhoea_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Diarrhoea
दस्त
 yesno, Required
1Yes
0No
778 [when_diarrhoea_6]
Show the field ONLY if:
[diarrhoea_6] = "1"
When
कब 		text
779 [how_many_times_diarrheaea_6]
Show the field ONLY if:
[diarrhoea_6] = "1"
How many times
कितनी बार 		text
780 [hair_fall_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Hair fall
बाल झड़ना
 yesno, Required
1Yes
0No
781 [when_hair_fall_6]
Show the field ONLY if:
[hair_fall_6] = '1'
When
कब 		text
782 [how_many_times_hair_fall_6]
Show the field ONLY if:
[hair_fall_6] = '1'
How many times
कितनी बार 		text
783 [itching_and_rashes_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Itching and rashes
खुजली और चकत्ते
 yesno, Required
1Yes
0No
784 [when_itching_6]
Show the field ONLY if:
[itching_and_rashes_6] = "1"
When
कब 		text
785 [how_many_times_itching_6]
Show the field ONLY if:
[itching_and_rashes_6] = "1"
How many times
कितनी बार 		text
786 [headaches_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Headaches
सिर दर्द
 yesno, Required
1Yes
0No
787 [when_headaches_6]
Show the field ONLY if:
[headaches_6] = "1"
When
कब 		text
788 [how_many_times_headaches_6]
Show the field ONLY if:
[headaches_6] = "1"
How many times
कितनी बार 		text
789 [eye_pain_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Eye pain
आँख का दर्द
 yesno, Required
1Yes
0No
790 [when_eye_pain_6]
Show the field ONLY if:
[eye_pain_6] = "1"
When
कब 		text
791 [how_many_times_eyepain_6]
Show the field ONLY if:
[eye_pain_6] = "1"
How many times
कितनी बार 		text
792 [alcohol_locally_fermented_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Alcohol / Locally Fermented Beer (Mahua, Whisky, Rum, Beer, Other (Mahua; Whisky; Rum; any other / महुआ; व्हिस्की; रम; कोई और) descriptive
793 [who_consumes_alcohol_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Who consumes alcohol? radio, Required
1You/ आप
2Family member/ परिवार के सदस्य
3Both / दोनों
794 [do_you_consume_alcohol_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Do you consume alcohol? yesno, Required
1Yes
0No
795 [how_do_you_consume_6]
Show the field ONLY if:
[do_you_consume_alcohol_6] = '1'
How do you consume? radio, Required
1Regular/ नियमित
2Occasional/प्रासंगिक
796 [at_what_age_did_you_start_6]
Show the field ONLY if:
[do_you_consume_alcohol_6] = '1'
At what age did you start consuming alcohol? text (number), Required
797 [frequency_of_alcohol_consu_6]
Show the field ONLY if:
[how_do_you_consume_6] = '1'
Frequency of alcohol consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
5Occasional
798 [quantity_of_alcohol_consum_6]
Show the field ONLY if:
[how_do_you_consume_6] = '1'
Quantity of alcohol consumed per day (average in ml): text (number), Required
799 [do_you_take_during_pregnan_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Do you take during pregnancy?
क्या आप गर्भावस्था के दौरान लेते हैं?
 radio, Required
1Yes
2No
3Not Applicable
800 [frequency_per_day_during_p_6]
Show the field ONLY if:
[do_you_take_during_pregnan_6] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
801 [tobacco_pan_chewing_smokin_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Tobacco / Pan (Chewing, Smoking, Beedi, Cigarette, Zarda, Other ( चबाना; धूम्रपान; प्रत्यक्ष तम्बाकू; बीड़ी; सिगरेट; ज़र्दा; कोई और ) descriptive
802 [who_consumes_tobacco_pan_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Who consumes tobacco/pan? radio, Required
1You
2Family member
3Both
803 [do_you_consume_tobacco_pan_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Do you consume tobacco/pan? yesno, Required
1Yes
0No
804 [how_do_you_consume_tobacco_6]
Show the field ONLY if:
[do_you_consume_tobacco_pan_6] = '1'
How do you consume tobacco/pan? radio, Required
1Regular
2Occasional
805 [what_form_of_tobacco_pan_d_6]
Show the field ONLY if:
[do_you_consume_tobacco_pan_6] = '1'
What form of tobacco/pan do you use? checkbox, Required
1what_form_of_tobacco_pan_d_6___1Chewing
2what_form_of_tobacco_pan_d_6___2Smoking
3what_form_of_tobacco_pan_d_6___3Beedi
4what_form_of_tobacco_pan_d_6___4Cigarette
5what_form_of_tobacco_pan_d_6___5Zarda
6what_form_of_tobacco_pan_d_6___6Other (please specify)
806 [other_specify_6]
Show the field ONLY if:
[what_form_of_tobacco_pan_d_6(6)] = '1'
Other Specify text
807 [at_what_age_did_you_tobacco_6]
Show the field ONLY if:
[do_you_consume_tobacco_pan_6] = '1'
At what age did you start consuming tobacco/pan? text (number), Required
808 [frequency_of_tobacco_pan_c_6]
Show the field ONLY if:
[how_do_you_consume_tobacco_6] = '1'
Frequency of tobacco/pan consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
809 [quantity_consumed_per_day_6]
Show the field ONLY if:
[how_do_you_consume_tobacco_6] = '1'
Quantity consumed per day (average): text, Required
810 [do_you_take_tobacco_pan_du_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Do you take tobacco/pan during pregnancy? radio, Required
1Yes
2No
3Not Applicable
811 [frequency_per_day_tobaco_pre_6]
Show the field ONLY if:
[do_you_take_tobacco_pan_du_6] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
812 [other_drugs_charas_ganja_b_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Other Drugs (Charas, Ganja, Bhang, Opium, LSD, Brown Sugar, Other)(चरस; गांजा; भांग; अफ़ीम; एल.एस.डी.; ब्राउन शुगर; कोई और) descriptive
813 [who_consumes_other_drugs_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Who consumes other drugs? radio, Required
1You
2Family member
3Both
814 [do_you_consume_other_drugs_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Do you consume other drugs? yesno, Required
1Yes
0No
815 [how_do_you_consume_other_d_6]
Show the field ONLY if:
[do_you_consume_other_drugs_6] = '1'
How do you consume other drugs? radio, Required
1Regular
2Occasional
816 [what_type_of_drug_do_you_u_6]
Show the field ONLY if:
[do_you_consume_other_drugs_6] = '1'
What type of drug do you use? checkbox, Required
1what_type_of_drug_do_you_u_6___1Charas
2what_type_of_drug_do_you_u_6___2Ganja
3what_type_of_drug_do_you_u_6___3Bhang
4what_type_of_drug_do_you_u_6___4Opium
5what_type_of_drug_do_you_u_6___5LSD
6what_type_of_drug_do_you_u_6___6Brown Sugar
7what_type_of_drug_do_you_u_6___7Other (please specify)
817 [specify_other_drug_6]
Show the field ONLY if:
[what_type_of_drug_do_you_u_6(7)] = '1'
Specify Other text
818 [at_what_age_did_you_star_drug_6]
Show the field ONLY if:
[do_you_consume_other_drugs_6] = '1'
At what age did you start consuming drugs? text (number), Required
819 [frequency_of_drug_consumpt_6]
Show the field ONLY if:
[how_do_you_consume_other_d_6] = '1'
Frequency of drug consumption per day: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
820 [quantity_consumed_per_day_drug_6]
Show the field ONLY if:
[how_do_you_consume_other_d_6] = '1'
Quantity consumed per day (average): text (number), Required
821 [do_you_take_drugs_during_p_6]
Show the field ONLY if:
[no_of_family_member] >= 6
Do you take drugs during pregnancy? radio, Required
1Yes
2No
3Not Applicable
822 [frequency_per_day_during_drug_6]
Show the field ONLY if:
[do_you_take_drugs_during_p_6] = '1'
Frequency per day during pregnancy: radio, Required
11 time/day
22-3 times/day
34-5 times/day
4More than 5 times/day
 
 823 [form_1_complete]
Section Header: Form Status
Complete? 		dropdown
0Incomplete
1Unverified
2Complete
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