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INTERVIEW SCHEDULE
TOPIC: - “EMPTY” NESS SYNDROME- ASTUDY OF CHANGING FAMILY
PATTERN IN KERALA.
SECTION – A. PERSONAL DATA
1. Name For Yes-1, No-2, N.A-3
2. Address
3. Sex: M/F
4. Age 60-64, 65-69, 70-74, 75-80, + 80 1-2-3-4-5
5. Religion: Hindu/ /Christian/Muslim
6. Educational Qualification: Below SSLC/ SSLC/ Pre-Degree/ Degree/ Post
Graduate/ Others 1-2-3-4-5-6
7. Occupation? Retd. Non govt.empl/ Retd. Govt.empl
Agri./ Business/ Labourer/ others 1-2-3-4-5
8. Monthly Income? Below 5000 / 5000-9999/ 10,000
14999/15,000-19999/+20,000 1-2-3-4-5
9 Marital status? Married/ Divorced/Separated/widower 1-2-3-4
10. Place of residence: Rural/Urban 1-2