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Questions marked with a * are required Exit Survey
 
 
* Respondent’s Number
   
 
 
 
* Lok Sabha Name
   
 
 
 
* Lok Sabha CODE
   
 
 
 
* Assembly Name
   
 
 
 
* Assembly CODE
   
 
 
 
Polling stations Name
   
 
 
 
Polling stations CODE
   
 
 
 
Location
 
Urban 1
 
Rural 2
 
 
 
G1-Name of the Respondent
   
 
 
 
Address
   
 
 
 
Phone No
   
 
 
 
Sex of the Respondent
 
Male 1
 
Femaie 2
 
 
 
Age of the Respondent
 
18-25 years
 
26-45 years
 
Above 46 years
 
 
 
Education
 
Illiterate
 
Literate, no schooling
 
School
 
College
 
 
 
Occupation
 
Housewife
 
Unemployed
 
Student
 
Employed
 
Labourer
 
Business
 
Farmer
 
Other
 
 
 
Income Group
 
LIG (<5000)
 
MIG (6 to 20000)
 
HIG > 20000
 
 
 
Caste
 
Brahmin
 
Karan
 
Khandayat
 
Marwari
 
 
 
In whatever financial condition you are placed today, on the whole are you satisfied or dissatisfied with it?
 
Fully Satisfied
 
Somewhat Satisfied
 
Somewhat dissatisfied
 
Fully dissatisfied
 
Can’t Say
 
 
 
How would you rate the economic situation of the state at the moment?
 
Very Good
 
Good
 
So-so
 
Bad
 
Very Bad
 
Can’t Say
 
 
 
What are the 2 most important problems of your everyday life?
 
Electricity problem
 
Roads
 
Drinking water
 
Sanitation
 
Health
 
School/College
 
Housing
 
Price Rise
 
Corruption
 
Unemployment
 
Poverty
 
irrigation
 
PDS procurement
 
Ration Problems
 
Law & Order
 
Other problems

 
 
 
Who do you blame for above stated problems?
 
State Government
 
Central Government
 
Local Administration
 
MP/MLA
 
Local Politicians
 
Others
 
No Response

 
 
 
Control of corruption
 
Improved
 
Remained Same
 
Deteriorated
 
Can’t Say
 
 
 
Condition of roads in your area
 
Improved
 
Remained Same
 
Deteriorated
 
Can’t Say
 
 
 
Supply of electricity in your area
 
Improved
 
Remained Same
 
Deteriorated
 
Can’t Say
 
 
 
Supply of drinking water in your area
 
Improved
 
Remained Same
 
Deteriorated
 
Can’t Say
 
 
 
Irrigation facilities in your area
 
Improved
 
Remained Same
 
Deteriorated
 
Can’t Say
 
 
 
Condition of farmers in your area
 
Improved
 
Remained Same
 
Deteriorated
 
Can’t Say
 
 
 
Condition of educational system
 
Improved
 
Remained Same
 
Deteriorated
 
Can’t Say
 
 
 
Relations between religious groups
 
Improved
 
Remained Same
 
Deteriorated
 
Can’t Say
 
 
 
Condition of govt. hospitals in your area
 
Improved
 
Remained Same
 
Deteriorated
 
Can’t Say
 
 
 
Employment opportunities
 
Improved
 
Remained Same
 
Deteriorated
 
Can’t Say
 
 
 
 
 
Improved
 
Remained Same
 
Deteriorated
 
Can’t Say
 
 
 
 
 
Improved
 
Remained Same
 
Deteriorated
 
Can’t Say
 
 
 
 
 
Improved
 
Remained Same
 
Deteriorated
 
Can’t Say