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Department of Community Medicine 
VMCH & RI, Madurai 
Village health Survey 
S.No. Question Options 
1. Name of the village 
2. Location 
1. Near main road 
2. Away from main road 
3. Streets 
1. Pucca 
2. Kutcha 
3. Mixed 
4. Drainage 
1. Underground drains 
2. Open drains 
3. No drains 
5. Major source water supply 
1. Wells 
2. Hand pumps 
3. Tubewells 
4. Ponds 
5. Taps 
6. Others 
6. Water supply type 
1. Individual 
2. Community type 
7. Refuse disposal 
1. Within house 
2. Thrown 
indiscriminately 
3. Public dust bin 
4. Community waste 
disposal 
8. Latrine usage 
1. Community latrines 
2. House latrines 
3. Fields 
4. Streets 
5. Ponds 
6. Others
9. Houses situation 
1. Compact 
2. Clustered 
3. Widely scattered 
10. 
Rodents and insects 
a. Flies 
1. Summer 
2. Winter 
3. Rain 
11. 
b. Mosquitoes 
1. Summer 
2. Winter 
3. Rain 
12. 
c. Rats 
1. Summer 
2. Winter 
3. Rain 
13. 
d. Cockroaches 
1. Summer 
2. Winter 
3. Rain 
14. Total number of houses 
15. Total area of the village (in Sq.ft) 
16. Total Population 
17. Total no. of Males 
18. Total no. of Females 
19. General composition of families 
1. Single 
2. Joint 
3. Extended 
20. Planning of the village 
1. Planned 
2. Unplanned 
21. Recreational places 
1. None 
2. Park 
3. Community centre 
4. Others___________ 
22. School 
1. Yes 
2. No 
23. Type of school 
1. Government 
2. Private 
24. Voluntary agencies working in the area 
Other comments:

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Village Health Survey by Department of Community Medicine

  • 1. Department of Community Medicine VMCH & RI, Madurai Village health Survey S.No. Question Options 1. Name of the village 2. Location 1. Near main road 2. Away from main road 3. Streets 1. Pucca 2. Kutcha 3. Mixed 4. Drainage 1. Underground drains 2. Open drains 3. No drains 5. Major source water supply 1. Wells 2. Hand pumps 3. Tubewells 4. Ponds 5. Taps 6. Others 6. Water supply type 1. Individual 2. Community type 7. Refuse disposal 1. Within house 2. Thrown indiscriminately 3. Public dust bin 4. Community waste disposal 8. Latrine usage 1. Community latrines 2. House latrines 3. Fields 4. Streets 5. Ponds 6. Others
  • 2. 9. Houses situation 1. Compact 2. Clustered 3. Widely scattered 10. Rodents and insects a. Flies 1. Summer 2. Winter 3. Rain 11. b. Mosquitoes 1. Summer 2. Winter 3. Rain 12. c. Rats 1. Summer 2. Winter 3. Rain 13. d. Cockroaches 1. Summer 2. Winter 3. Rain 14. Total number of houses 15. Total area of the village (in Sq.ft) 16. Total Population 17. Total no. of Males 18. Total no. of Females 19. General composition of families 1. Single 2. Joint 3. Extended 20. Planning of the village 1. Planned 2. Unplanned 21. Recreational places 1. None 2. Park 3. Community centre 4. Others___________ 22. School 1. Yes 2. No 23. Type of school 1. Government 2. Private 24. Voluntary agencies working in the area Other comments: