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Full food and financial crisis impact questionnaire - Gender ...

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Name of the Item code Did you<br />

consume it<br />

in the last 3<br />

days<br />

Yes=1->5<br />

No=2->4<br />

Did you<br />

consume it<br />

in the last 7<br />

days<br />

Yes=1<br />

No=2<br />

Total quantity<br />

consumed<br />

Unit of<br />

measure<br />

Kg ............. 1<br />

Grams ....... 2<br />

Liter .......... 3<br />

Number ..... 4<br />

(applicable<br />

for all<br />

consumption<br />

items)<br />

If the<br />

unit of<br />

measu<br />

re is<br />

numbe<br />

r, then<br />

write<br />

the<br />

averag<br />

e<br />

weight<br />

in<br />

grams<br />

20<br />

Quantityconsumed from Purchase <strong>food</strong><br />

Quantity<br />

consumed<br />

Unit<br />

price<br />

Total<br />

value<br />

(taka)<br />

Did you<br />

purchase<br />

this <strong>food</strong><br />

on credit<br />

Yes...1<br />

No....2<br />

Quantity<br />

from own<br />

production<br />

Quantity from<br />

other sources<br />

1 2 3 4 5 6 7 8 9 10 11 12 13 14<br />

Onion 63<br />

Garlic 64<br />

Dhundal 65<br />

Shapla 66<br />

Kachur lati 67<br />

Jhinga (ribbed gourd) 68<br />

Green pea 69<br />

Fig 70<br />

Drum stick 71<br />

Snake gourd 72<br />

Green jackfruit 73<br />

Kolar mocha 74<br />

Mete alu 75<br />

Beher gura 76<br />

Soybean bori 77<br />

Jack fruit seed 78<br />

Cabbage 79<br />

Other<br />

Leafy vegetables<br />

Pui (Indian spinach) 80<br />

Lal Shak (red amaranth) 81<br />

Bathua 82<br />

Bokful 83<br />

Cabbage 84<br />

Danta Shak 85<br />

Helencha 86<br />

Kalmi Shak 87<br />

Kachu Shak 88<br />

Kalo kachu Shak 89<br />

Katanate 90<br />

Lau Shak 91<br />

Pat Shak 92<br />

Dheki Shak 93<br />

Quantity<br />

Source<br />

(code1)

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