IDENTIFICATION DETAILS
SL. NO Particulars
1 FARMER NAME:
2 HUSBAND’S NAME :
3 CONTACT NO:
4 DISTRICT 1. East Champaran 2. Nalanda
5 BLOCK
6 GRAM PANCHAYAT
7 VILLAGE
8 PG NAME
9 VO NAME
10 SHG NAME
Is there a TechnoServe intervention on-going in this village?
11 Yes...1 No....2
Are you engaged in Contract Farming?
12 Yes...1 No....2
If Yes, off the total land, on how much land are you doing contract farming
2 Land/orchard leased-in by
farmer(taken for cultivation from
others) in Acres
3 Land leasing cost (Rs)
(Add this cost in Table no 11)
4 Actual land cultivated in Acres
___________________________________________
3. Inputs Used
SL No Particular Units used Unit Cost (Rs) Total Total cost
1 Tractor
2 Animal
3 Farm Yard Manure
4 Any other
(specify……………….)
5 Any other
(specify……………….)
6 Total expenses on Inputs Used (Rs)
4. Irrigation Details
1 Source of irrigation: Tank/Canal/Bore well/Open well 1
Canal 2
Bore well 3
Open well 4
2 Total number of irrigation
______________________
3 Interval of Irrigation Once in Three days 1
Weekly 2
Monthly 3
4 Labour cost for Irrigation Amount.______________
8. Weeding Costs
SL NO Period Male Female Total cost of weeding (Rs)
Quantity Amount Quantity Amount
1 First time
2 Second time
3 Third time
4 Any other
(specify………..)
5 Total expenses on weeding
9. Harvesting Costs
SL No Labour used Total cost incurred (Rs)
Male Female
Quantity Amount Quantity Amount
1
2
3
4
5 Total expenses on harvesting
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