Progress report for the month of -----------, 200-

1.Basic Information:

a. village name:
block name:
district name:

b. micro-watershed name:
micro-watershed code no.:

c. scheme:
WORKS (DETAILS)

1. TREE- PLANTATION:

land area covered (ha) no.of saplings

species community
private total private community total
forest non-forest gochar total
plantation (contd.)

cost details

costs incurred (Rs.)

till last month during the month cumulative

species plant labour plant labour plant labour
seedling other total seedling other total seedling other total
protection charges protection charges protection charges

species contribution to WDF

amount(rupees) proportion of total costs(%)
plantation (contd.)

benefits

households benefitted employment generated

species rupees
SC ST general total BPL no. of man days
contract/daily wage
AREA TREATMENT

physical progress:

treatment quantity(no.s) land area treated(ha) land area benefitted(ha)

undertaken till last during the common common
cumulative private total private total
month month forest nonforest gochar total forest non-forest gochar total
AREA TREATMENT (CONTD.)

financial details:

treatment costs incurred (rupees) contribution to WDF

undertaken material labour other total Amount proportion of total costs(%)
area treatment (contd.)

benefits

treatment households benefitted employment generated

undertaken rupees
SC ST general total BPL no. of man-days
contract/daily wage
DRAINAGE LINE TREATMENT

physical progress

Treatment quantity(no.s) land area benefitted(ha)

undertaken till last during the common
cumulative private total
& (no.s) month month forest non-forest gochar total
drainage line treatment (contd.)

financial details:

Treatment costs incurred contribution to WDF

undertaken material labour other total Amount proportion of total costs(%)
drainage line treatment (contd.)

treatment households benefitted employment generated

undertaken rupees
SC ST GEN total BPL no. of man days
contract/ daily wage
IRRIGATION INFRASTRUCTURE

physical progress

work individual/ conservation

land area covered(ha)
undertaken community capacity
irrigation infrastructure(contd.)

financial details:

work costs incurred (Rs.) contribution to WDF

undertaken material labour other total Amount proportion of
(Rs.) total costs (%)
irrigation infrastructure(contd.)

benefits

work irrigation potential households benefitted employment generated

undertaken created(Ha s of land) rupees
SC ST GEN Total BPL no. of man days
contract/ daily wage
LIVESTOCK INTEVENTIONS

activity contribution to WDF no. of households benefitted

costs incurred (Rs.)
undertaken amount proportion
SC ST general total BPL
(Rs.) of expense(%)
AGRICULTURE

activity quantity area to be covered costs incurred contribution to WDF households benefitted
undertaken no.s/kg (ha) (Rs.) amount proportion of SC ST general total BPL
(Rs.) expense(%)
WDF and user groups details

WDF status:

WDF contributions during the month WDF

activities amount proportion nature of
opening balance users group closing balance
(Rs.) of expense (%) contribution

USERS GROUPS DETAILS:

No. till last month during the month total

members enrolled

male female
till last during the till last during the
total total
month month month month
MEETINGS DETAILS

FOR BENEFICIARIES / COMMUNITY

type/ participants
date venue duration issues discussed decisions taken follow-up actions
committee male female

FOR STAFF

participants
type date venue duration issues discussed decisions taken follow-up actions
male female
TRAININGS DETAILS

FOR BENEFICIARIES / COMMUNITY

no. of participants resource

sl.no. purpose date venue duration remarks
male female persons

FOR STAFF

no. of participants resource

sl.no. purpose date venue duration remarks
male female persons
SELF HELP GROUPS

self help groups without external assistance

name of no. of members opening balance deposits

group cash in cash in loan current interest loan interest from other
male female total fine total
hand bank outstanding savings from bank repaid loanee income

name of payment closing balance

group loan cash in cash in loan
expenses total total
disbursal hand bank outstanding
SELF HELP GROUPS

self help groups with external assistance

name of no. of members opening balance

group cash in cash in loan outstanding
male female total
hand bank external group

name of deposits
group current interest loan interest from loanee revolving loan / grant other total
fine
savings from bank repaid internal external fund amount source of income
assistance
SELF HELP GROUPS

self help groups with external assistance

name of payment closing balance

group revolving fund cash in cash in loan outstanding
external loan repaid loan disbursal expenses total total
repayment hand bank external group
SHG(CONTD.)

income generating activity (if any)

Name nature no. of members proportion of
activity
group/individual involved members involved

no. of meetings record maintenance linkage with

name mode of collection
held (by whom) financial institutions
EDUCATION DETAILS:

CHILDREN EDUCATION

school days enrolled enrolled attendance 0 days attendance 1-9 days attendance 10-15 days attendance 16-20 days attendance >20 days
type open boys girls boys girls boys girls boys girls boys girls boys girls

ADULT EDUCATION

year, month learning males learning females improving males improving females literate males literate females
HEALTH DETAILS:

GROWTH MONITORING

year eligible normal average malnourished absent

month male female male female male female male female male female

ILLNESSES

year Fever Malaria Typhoid Jaundice

month checked detected treated checked detected treated checked detected treated checkeddetected treated

year Diarrhoea other

specify other
month checked detected treated checked detected treated

year Night Blindness Scabies

month newly under newly under
checked detected cured checked detected cured
registeredtreatment registeredtreatment

year TB Leprosy Other

month newly under newly under newly under
checked detected cured checked detected cured checked detected cured
registeredtreatment registeredtreatment registered treatment
HEALTH DETAILS:

BIRTH DETAILS:

year parents name live or still

HH code sex
month father mother birth

DEATHS

year
name age sex HH code head of household cause of death
month
HEALTH DETAILS:

IMMUNISATION

year BCG male BCG female DPT/ OPV1 male DPT/ OPV1 female DPT/OPV2 male DPT/OPV2 female
month eligible benefitted eligible benefitted eligible benefitted eligible benefitted eligible benefitted eligible benefitted

year DPT/ OPV3 male DPT/ OPV3 female Measles male Measles female Booster male Booster female
month eligible benefitted eligible benefitted eligible benefitted eligible benefitted eligible benefitted eligible benefitted

ANTE- NATAL CARE

year previous new TT1 TT2 TT TT Iron Calcium

delivered aborted
month total total given given booster not given given given