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SURVEY REPORT

A SURVEY ON SELF MEDICATION-


PERCEPTION OF HOUSEWIVES IN
MUMBAI
SAMPLE SIZE [N=620]

Conducted on 8TH July 2009


COMPILED & SUBMITTED BY:

Bharti Mandalia
Palkesh Sancheti
Priyadarshini S.
Rinkesh Shah
Swapna Gujja

A Survey carried out by students of First Year,


MBA- Pharmaceuticals Management, Section-
B, NMIMS, Mumbai,
As a part of the coursework
“LISTENING TO STAKEHOLDERS”
N= 620

ACKNOWLEDGEMENTS:

We wish to thank our Professors, Dr (Prof.) Tarun Gupta


(Chairman, Pharmaceuticals Management and Senior Prof.,
Marketing, SBM, NMIMS, Mumbai) and Mrs. Savita Chari
for data analysis.

We also thank all our respondents (Housewives) located in


the various zones of Mumbai for their time and co-
operation, which enabled us to successfully complete the
project and compile this report.

The survey was carried out by all students of the First year
MBA-Pharmaceuticals Management, Section-B, NMIMS,
Mumbai.

2
N= 620

INDEX

SR.NO CONTENTS PAGE NO.

A. EXECUTIVE SUMMARY 4

B. RESEARCH OBJECTIVE 9

C. SAMPLE BREAK-UP 10-11

1. Zone Wise 10

2. Academic Qualification Wise 10

3. Age Group Wise 11

4. Family Member Wise 11

If any person in your family has the following diseases,


Q.1 12-44
then what is the treatment that you suggest?

i. HEADACHE 12
ii. COUGH AND COLD 16
iii. FEVER 21
iv. VOMITTING 25
v. BAD STOMACH 29
3
N= 620

vi. ACIDITY 34
vii. SPRAINS AND PAINS 38
viii. SORE THROAT 42
ix. TOOTHACHE 47

Q.2 Do you have a Family Doctor/Physician? 51

D. Annexure : List of Housewives 52

E. Annexure : Questionnaire 69

EXECUTIVE SUMMARY

1. Treatments preferred by Housewives for:

i. Headache
• 49% Housewives prefer Crocin.
• 21% Housewives prefer Topical Applications like Vicks balm,
Amrutanjan balm, etc.
• 11% Housewives use Home Remedies like Oil massage, hot
beverages, Steam inhalation, etc.
• 3% Housewives prefer taking rest.
• 2% Housewives avoid taking medicines.

ii. Cough and Cold


4
N= 620

• 32% Housewives prefer Home Remedies for Cough & Cold like
Steam inhalation and Gargling.
• 20% Housewives prefer Allopathic Medicines like Crocin, D-cold,
and Vicks Action 500, etc.
• 14% Housewives prefer to consult the Doctor.
• 13% Housewives prefer Cough Syrups like Benadryl, Glycodin,
etc.

iii. Fever
• 68% Housewives prefer Crocin.
• 28% Housewives prefer Consulting the Doctor.
• 4% Housewives use Home Remedies like wet cloth on forehead,
applying onion on forehead, drinking boiled water, etc.
• 3% Housewives prefer Ayurvedic Medicines like sudharshan
tablet, tulsi kadha etc.

iv. Vomiting

5
N= 620

• 27% Housewives prefer Home Remedies like Lemon juice, butter


milk, camphor, cardamom, ginger, ajowan, etc.
• 26% Housewives prefer Consulting the Doctor.
• 18% Housewives prefer Allopathic medicines like Avomine,
Domestal, Rantac, Vomistop, etc.
• 7% Housewives never experienced Vomiting.

v. Bad Stomach
• 45% Housewives uses Home Remedies like Drinking coffee,
Buttermilk, Ajowan, Asafoetida, etc.
• 28% Housewives prefer Allopathic Medicines like Gelusil,
Lomotil, Cyclopam, Norflox, etc.
• 7% Housewives take Pudin Hara.
• 4% Housewives take Lomotil.
vi. Acidity
• 44% Housewives prefer Allopathic medicines like Gelusil,
Digene, Zinetac, Pantocid, Rantac, etc.
• 32% Housewives use Home Remedies like Milk, lemon juice,
Amla, Ajowan, etc.
• 6% Housewives never experienced Acidity.
6
N= 620

• 4% Housewives prefer Ayurvedic Medicines like Raj bindu,


Panchavati, Triphala churna, jeevan mixture, etc.

vii. Sprains and Pains


• 54% Housewives prefer Topical Applications like Moov, Iodex,
etc.
• 17% Housewives prefer Allopathic Medicines like Combiflam,
Brufen, etc.
• 15% Housewives use Home Remedies like Oil massage, Hot
water treatment, Bandages, Turmeric paste, etc.
• 5% Housewives prefer to Consult the Doctor.

viii. Sore Throat


• 50% Housewives prefer Gargling with Warm Salt Water,
Turmeric, Ghee, etc.
• 22% Housewives prefer Home Remedies like Turmeric
Milk, Ginger, Tulsi, Steam inhalation, etc.
• 11% Housewives prefer to Consult the Doctor.
• 6% Housewives have Never Experienced Sore Throat.

ix. Toothache

7
N= 620

• 37% Housewives prefer to Consult the Doctor.


• 27% Housewives use Home remedies like Clove oil, gargling,
etc.
• 18% Housewives prefer Allopathic Medicines Painkillers,
Combiflam etc.
• 7% Housewives said they had Never Experienced Tooth Ache.

Research Objective
8
N= 620

The objective of the survey is to listen to the Housewives and to


understand their Knowledge, Perception and Attitude on
Self Medication in case of general ailments.

Research Methodology
A structured questionnaire for the study subjects (Housewives) was
designed within the scope of given objectives. Mumbai was divided into
5 zones. Within each zones, Housewives were interviewed from different
areas.

The zones and areas covered are as follows:

ZONE SUBURBS

Dahisar, Borivali, Kandivli, Malad, Goregaon, Jogeshwari,


Western Suburbs Andheri, Vile Parle, Santacruz, Khar, Bandra.

South Mumbai Mumbai Central, Grant Road, Churchgate.

Eastern Suburbs Ghatkopar, Mulund.

9
N= 620

Central Mumbai Dadar, Bhandup, Sion, Wadala.

Thane Thane East and West

SAMPLE BREAK – UP

1) ZONE-WISE DISTRIBUTION OF HOUSEWIVES:


(N=620)

3) AGE WISE DISTRIBUTION OF HOUSEWIVES: (N=620)

4) FAMILY MEMBER WISE DISTRIBUTION OF


HOUSEWIVES:
(N=620 Families and 2993 Family Members)

Q.1- i
If any person in your family has the following
diseases, then what is the treatment that you
suggest?
10
N= 620

HEADACHE

Multiple Responses = 869

Treatments preferred for Headache

11
N= 620

PERCENTAGE
RESPONSE TOTAL
SR.NO OF
(Headache) RESPONSES:869
RESPONSES

I. ALLOPATHIC MEDICINES 434 50%

1. Crocin 213 49%

2. Responses like D-Cold,


Diclogem, Any Pain killers,
91 21%
Metacin, Nise, Vicks Action 500,
Paracetamol, Calpol, etc.

3. Saridon 55 13%

4. Disprin 32 7%

5. Anacin 17 4%

6. Combiflam 17 4%

7. Aspirin 4 1%
8. Novalgin 5 1%
I. TOPICAL APPLICATION 180 21%

1. Unspecific responses like apply


any Balm, massage with balm, 117 65%
etc.
2. Vicks 55 31%
3. Amrutanjan Balm 8 4%

I. HOME REMEDIES 95 11%


1. Home remedies like applying 12
N= 620

Interpretation: Headache
• 49% Housewives prefer Crocin.
• 21% Housewives prefer Topical Applications like Vicks balm,
Amrutanjan balm, etc.
• 11% Housewives use Home Remedies like Oil massage, hot
beverages, Steam inhalation, etc.
• 3% Housewives prefer taking rest.
• 2% Housewives avoid taking medicines.

Q.1- ii
If any person in your family has the following
diseases, then what is the treatment that you
suggest?

COUGH & COLD


13
N= 620

Multiple Responses = 870

Treatments preferred for Cough & Cold

14
N= 620

RESPONSE TOTAL PERCENTAGE


SR.NO
(COUGH AND COLD) RESPONSES:870 OF RESPONSES
I. HOME REMEDIES 286 32%
1. Responses like brandy, clove,
hot soup, mint, onion juice, 59 20%
etc.
2. Steam Inhalation 50 17%
3. Turmeric 39 14%
4. Ginger 29 10%
5. Adulsa Syrup 25 9%
6. Honey 20 7%
7. Basil Leaves (Tulsi) 20 7%
8. Gargling 13 5%
9. Kaddha 10 4%
10.Ajowain 7 3%
11.Any Balms 7 3%
12.Hot water and milk with salt 6 2%
13.Garlic 1 1%
II. ALLOPATHIC MEDICINES 177 20%
1. Crocin 49 27%
2. D-cold 29 16%
3. Vicks Action 500 16 9%
4. Actifed 9 5%
5. Cetrizine 5 3%
6. Ambrodil 2 1%
15
N= 620

Interpretation: Cough and Cold

• 32% Housewives prefer Home Remedies like Brandy, clove,


steam inhalation, etc.
• 20% Housewives prefer Allopathic Medicines like Crocin, D-cold,
and Vicks Action 500, etc.
• 14% Housewives prefer to Consult the Doctor.
• 13% Housewives prefer Cough Syrups like Benadryl, Glycodin,
etc.

16
N= 620

Q.1- iii
If any person in your family has the following
diseases, then what is the treatment that you
suggest?

FEVER

17
N= 620

Multiple Responses =798

Treatments preferred for Fever

18
N= 620

TOTAL
SR.N RESPONSE PERCENTAGE
RESPONSES:79
O (FEVER) OF RESPONSES
8

I. ALLOPATHIC MEDICINES 465 58%

1. Crocin 318 68%

2. Responses like D-cold,


Panadol, Triple action,
65 14%
Saridon, Disprin, Coldarin
tablets, Aspirin, etc.

3. Metacin 53 11%

4. Nise 11 2%

5. Combiflam 10 2%

6. Calpol 8 1%

I. CONSULT THE DOCTOR 226 28%

UNSPECIFIC RESPONSES like taking


II. medicines from chemist, spiritual light, 38 5%
balm etc
HOME REMEDIES like keeping wet cloth
III. on forehead, applying onion on forehead, 35 4%
drinking boiled water etc.
19
N= 620

Interpretation: Fever

• 58% Housewives prefer Allopathic Medicines like Crocin, Metacin,


etc.
• 28% Housewives prefer Consulting the Doctor.
• 4% Housewives uses Home Remedies like wet cloth on forehead,
applying onion on forehead, drinking boiled water, etc.
• 3% Housewives prefer Ayurvedic Medicines like sudharshan
tablet, tulsi kadha etc.

Q.1- iv
20
N= 620

If any person in your family has the following


diseases, then what is the treatment that you
suggest?

VOMITING

Multiple Responses =712

21
N= 620

22
N= 620

Treatments preferred for Vomiting


PERCENTAGE
SR. RESPONSE TOTAL
OF
NO (VOMITING) RESPONSES:712
RESPONSES
I. HOME REMEDIES 192 27%
1. Lemon Juice 90 47%
2. Responses like drink lots of water,
butter milk,camphor,cold milk, brandy 74 39%
and sugar, etc.
3. Cardamom 12 6%
4. Ginger 12 6%
5. Ajowan 4 2%
I.
CONSULT THE DOCTOR 182 26%
II
ALLOPATHIC MEDICINES 130 18%
.
1. Domstal 57 42%

2. Responses likeDigene,Electrolyte
39 30%
powder,Rantac,Acidil tablet, etc.

3. Avomine 11 8%

4. Ondem 5 4%
5. Parinorm 10 8%

6. Stemcil 6 4%

7. Vomistop 5 4%

8. Gelusil 3 2%
23
N= 620

Interpretation:Vomiting

• 27% Housewives prefer Home Remedies like Lemon juice, butter


milk, camphor, cardamom, ginger, ajowan, etc.
• 26% Housewives prefer Consulting the Doctor.
• 18% Housewives prefer Allopathic medicines like Avomine,
Domestal, Rantac, Vomistop, etc.
• 7% Housewives never experienced Vomiting.
• 4% Housewives prefer Ayurvedic medicines like Amrit dhara,
Jeevan mixture, Pudin hara, Amlanashak kadha, etc.
• 3% Housewives prefer avoiding medicines.
• 1% Housewives prefers Homeopathic medicines.

Q.1- v
24
N= 620

If any person in your family has the following


diseases, then what is the treatment that you
suggest?

BAD STOMACH

Multiple Responses =811

25
N= 620

Treatments preferred for Bad Stomach

26
N= 620

SR.NO PERCENTAGE
RESPONSE TOTAL
OF
(BAD STOMACH) RESPONSES:811
RESPONSES

I. HOME REMEDIES 280 45%

1. Responses like Drinking Boiled


water, Cumin water, Drinking
167 60%
strong coffee, Drinking Ghee with
Tea, etc.

2. Lemon juice 31 11%

3. Ajowan 31 11%

4. Asafoetida (Hing) 18 6%

5. Fruits or fruit juices like Banana,


14 5%
Apple or Pomegranate

6. Curd 14 5%

7. Buttermilk 5 2%

I. ALLOPATHIC MEDICINES 176 28%


1. Responses like Anti diarrheal
medicines, Take any Pain killer
57 32%
from medical store, Gelusil,
Antibiotics, Electral powder, etc.
2. Quinolic compounds like Biquenol,
32 18%
27
N= 620

Interpretation: Bad Stomach

• 45% Housewives uses Home Remedies like drinking


strong coffee, Buttermilk, Ajowan, Asafoetida, etc.
• 28% Housewives prefer Allopathic Medicines like Gelusil,
Lomotil, Cyclopam, Norflox, etc.
• 7% Housewives take Pudin Hara.
• 4% Housewives take Lomotil.
• 3% Housewives take less food or avoid food.

Q.1- vi

28
N= 620

If any person in your family has the following


diseases, then what is the treatment that you
suggest?

ACIDITY

Multiple Responses =794

29
N= 620

Treatments preferred for Acidity

30
N= 620

SR. TOTAL PERCENTAGE


RESPONSE
NO RESPONSES: OF
(ACIDITY)
794 RESPONSES
I. ALLOPATHIC MEDCINES 347 44%
1. Gelusil 92 27%
2. Digene 78 22%
3. Eno 66 19%
4. Zinetac 31 9%
5. Others like any Antacid,Cremafin
30 9%
plus,Pantocid , etc.
6. Rantac 27 8%
7. Omez 7 2%
8. Aciloc 5 1%
I. HOME REMEDIES 256 32%
1. Cold Milk 111 43%
2. Unspecific responses like consume light
99 39%
food, cold drink, cold water, avoid tea, etc.
3. Lemon juice 13 5%
4. Ice-creams 12 5%
5. Ajowan 11 4%
6. Amla 5 2%
7. Banana 5 2%
I. NEVER EXPERIENCED 49 6%
II UNSPECIFIC RESPONSES like Not common,
. sleep, Any tablets, Hajmola tablets, No Acid tablet, 48 6%
etc.
II ➢ AYURVEDIC MEDICINES like Raj bindu, 31
N= 620

Interpretation: Acidity

• 44% Housewives prefer taking Allopathic medicines like Gelusil,


Digene, Zinetac, Pantocid, Rantac etc
• 32% Housewives uses Home Remedies like Milk, lemon juice,
Amla, Ajowan etc.
• 6% Housewives never experienced such problem
• 4% Housewives prefer Ayurvedic medicines like Raj bindu,
Panchavati, Triphala churna, jeevan mixture etc.
• 4% Housewives prefer Consulting the Doctor.

Q.1- vii
32
N= 620

If any person in your family has the following


diseases, then what is the treatment that you
suggest?

SPRAINS AND PAINS


Multiple Responses =854

33
N= 620

Treatment preferred for Sprains and


pains

SR. TOTAL PERCENTAGE


RESPONSE
NO RESPONSES:85 OF
(SPRAINS AND PAINS)
4 RESPONSES
I. TOPICAL APPLICATION 467 54%
1. Moov 133 28%
2. Responses like apply any balm,
129 28%
ointment, lep etc.
3. Iodex 114 24%
4. Relispray 52 11%
5. Voveran Gel 12 3%
6. Tiger Balm 9 2%
7. Zandu Balm 8 2%
8. Fast Relief 7 2%
II. ALLOPATHIC MEDICINES 152 17%
1. Responses like Nimesulide, any
48 32%
analgesic, tablets etc.
2. Combiflam 41 27%
3. Volini tablets 25 16%
4. Any Painkillers 20 13%
5. Brufen 11 7%
6. Crocin 7 5%
III. HOME REMEDIES 132 15%
1. Responses like aloevera gel, oil
63 48%
massages, etc.
2. Hot Water Treatment 35 27%
3. Bandages 20 15%
4. Turmeric Paste 14 11%
34
N= 620

Interpretation: Sprains and Pains

• 54% Housewives prefer Topical Applications like Moov, Iodex,


etc.
• 17% Housewives prefer Allopathic Medicines like Combiflam,
Brufen, etc.
• 15% Housewives use Home Remedies like Oil massage, Hot
water treatment, Bandages, Turmeric paste, etc.
• 5% Housewives prefer to consult the Doctor.
• 3% Housewives prefer Ayurvedic oil massage.
• 3% Housewives said they take rest, would sleep, take no
medication etc.

35
N= 620

Q.1- viii
If any person in your family has the following
diseases, then what is the treatment that you
suggest?

SORE THROAT

Multiple Responses =735

36
N= 620

37
N= 620

Treatments preferred for Sore Throat

TOTAL
RESPONSE PERCENTAGE
SR.NO RESPONSES:73
(SORE THROAT) OF RESPONSES
5
I. GARGLING 312 50%
1. Gargling with Salt water 182 58%
2. Gargling with plain water 65 21%
3. Warm Water Gargling 50 16%
4. Gargling with Turmeric and Ghee 11 4%
5. Gargling with Mouthwashes 2 1%
6. Gargling with Tantum or Betadine 2 1%
II. HOME REMEDIES 138 22%
1. Using Turmeric or Turmeric in Milk 33 24%
2. Ginger 12 9%
3. Drinking Warm Water 8 6%
4. Honey 8 6%
5. Steam Inhalation 7 6%
6. Basil Leaves (Tulsi) 4 3%
7. Responses like Alum, Almond,
Soups, Cold Milk, Icecream,
Eucalyptus Oil, Wet Grapes, 67 49%
Garlic, Brandy, Clove, Tea, Pepper,
Kaadha, etc.
III. CONSULT THE DOCTOR 69 11%

IV. NEVER EXPERIENCED 36 6%

V. UNSPECIFIC RESPONSES 36 6%
38
N= 620

Interpretation: Sore Throat

• 50% Housewives prefer Gargling with Warm Salt Water,


Turmeric, Ghee, etc.
• 22% Housewives prefer Home Remedies like Turmeric
Milk, Ginger, Tulsi, Steam, etc.
• 11% Housewives prefer to consult the Doctor.
• 6% Housewives have Never Experienced Sore Throat.
• 6% Housewives prefer Other Remedies like Tablets, Yoga.
• 5% Housewives prefer Vicks.

Q.1- ix

39
N= 620

If any person in your family has the following


diseases, then what is the treatment that you
suggest?

TOOTH ACHE

Multiple Responses =750

40
N= 620

Treatments preferred for Tooth Ache


NUMBER
SR. RESPONSE PERCENTAGE
of
NO (Tooth Ache) Of responses
responses:750

I. CONSULT THE DOCTOR 279 37%

II. HOME REMEDIES 203 27%


1. Clove oil 142 70%

2. Responses like brushing


57 28%
with salt, using glycerin etc.

3. Gargling 04 2%

III ALLOPATHIC MEDICINES 138 18%

1. Combiflam 63 46%
2. Responses like
antibiotics, Crocin, 43 31%
Diclogem, etc.
3. Any Painkillers 28 20%
4. Brufen 04 3%
IV. NEVER EXPERIENCED 55 7%
V. UNSPECIFIC RESPONSES 28 4%

41
N= 620

responses like any medicines,


tablets etc.
VI. AYURVEDIC MEDICINES 24 3%

1. Gumex 8 33%

VII. DID NOT ANSWER 14 2%

VIII. HOMEOPATHIC MEDICINES 05 1%


Interpretation: Tooth Ache

➢ 37% Housewives prefer to consult the Doctor.

➢ 27% Housewives use Home remedies like Clove oil, gargling, etc.

➢ 18% Housewives prefer Allopathic Medicines Painkillers, Combiflam

etc.

➢ 7% Housewives said they had Never Experienced Tooth Ache.

➢ 3% Housewives prefer Ayurvedic Medicines like Gumex.

➢ 1% Housewives prefer Homeopathic Medicines.

42
N= 620

Q.2
Do you have a family Doctor / Physician?
(N = 620)

LIST OF HOUSEWIVES
Total- 620

43
N= 620

RESPONDENTS- AREA RESPONDENTS-HOUSEWIVES AREA


HOUSEWIVES
Mrs. Preeti Jain Khar Mrs. Ritu Gaitond Goregaon (E)
Mrs. Lavina Advani Khar Mrs. Kirti Bhati Goregaon (E)
Mrs. Deepa Khar Mrs. Arundhati Totade Goregaon (E)
Balchandani
Mrs. Geeta Bajaj Khar Mrs. Sneha Pratkar Goregaon (E)
Mrs. Jaya khurana Khar Mrs. S.S.Dandekar Goregaon (E)
Mrs. Sheela Jain Khar Mrs. Radha Sawant Goregaon (E)
Mrs Bharti Shah Khar Mrs. Mugdha Sawant Goregaon (E)
Mrs. Soniya Advani Khar Mrs. S.V.Kavishwar Goregaon (E)
Mrs. Alka Shah Khar Mrs. Pratima Shah Goregaon (E)
Mrs. Mamta Lakhyani Khar Mrs. Tirupti Goregaon (E)
Mrs. Kamla Punjabi Khar Mrs. Maniben Goregaon (E)
Mrs. Sudha Sehgal Khar Mrs. Heena Satra Goregaon (E)
Mrs. Charmi Bellare Khar Mrs. Jyoti Gala Goregaon (E)
Mrs. Lalita Mehta Khar Mrs. Dave Vile Parle (W)
Mrs. Jaya Nagdev Khar Mrs. Neha Vora Vile Parle (W)
Mrs. Vinni Hingurani Khar Mrs. Bhavana Haresh Vile Parle (W)
Mrs. Purvi Thakkar Khar Mrs. Jagruti Desai Vile Parle (W)
Mrs. Preeti Balchandani Khar Mrs. Madhuri Tank Vile Parle (W)
Mrs. Deepti Khar Mrs. Niranjana Vyas Vile Parle (W)
Balchandani
Mrs. Dolly Ghosh Khar Mrs. Bansari Pandit Vile Parle (W)
Mrs. Pushpa Lala Khar Mrs. Rupa Shah Vile Parle (W)
Mrs. Savita Khar Mrs. Kiran Kamdar Vile Parle (W)
vijayvargiya
Mrs. Shruti Shah Wadala Mrs. Preeti Parikh Vile Parle (W)
Dedhia
Mrs. Gladys Kotian Wadala Mrs. Forum Thanawala Vile Parle (W)
RESPONDENTS- AREA RESPONDENTS- AREA
HOUSEWIVES HOUSEWIVES
44
N= 620

QUESTIONNAIRE
SVKM’s NMIMS University

MBA, Pharmaceuticals Management, Ist yr. Trim. I, Section B

HOUSEWIFE SURVEY
Good morning / Good Afternoon / Good Evening. I am
__________________________ from NMIMS University conducting a survey for
housewives only.

Q 1. If any person in your family has the following diseases, then what is
the treatment that you suggest?

45
N= 620

(a) Headache
__________________________________________________________________
__________________________________________________________________

(b)Cough & Cold


__________________________________________________________________
__________________________________________________________________

(c) Fever
__________________________________________________________________
__________________________________________________________________

(d)Vomiting
__________________________________________________________________
__________________________________________________________________

(e) Bad stomach


__________________________________________________________________
__________________________________________________________________

(f) Acidity
__________________________________________________________________
__________________________________________________________________

46
N= 620

(g)Sprains and Pains


__________________________________________________________________
__________________________________________________________________

(h)Sore Throat
__________________________________________________________________
__________________________________________________________________

(i) Tooth Ache


__________________________________________________________________
__________________________________________________________________

Q 2. Do you have a family doctor/ physician?

Yes No

CLASSIFICATION DATA

Name: ________________________________ Area:


___________________________

Academic Background: _______________________

Age Group:

<25 yrs 26 to 35yrs 36 to 45 yrs

46 to 50 yrs >50 yrs

47
N= 620

Academic Qualification: ____________

No. of family members: ____________

Adults: ____________ Children: ____________

Thank you very much for your valuable time.

48

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