Anganwadis for Equality: A
Data collection Form
Name of Name of Name of Mother Age Caste Qualification
District Village/Town (In Years) (SC/ST/OBC/
GEN)
M/GARH M/GARH Neelam w/o Kishore kumar 20 GEN 10th
M/GARH M/GARH Monika w/o Ankit 30 GEN graduation+B.ed
M/GARH M/GARH Prachi w/o Sachin 23 GEN 12th
M/GARH M/GARH Babita w/o Arun 28 GEN graduation
M/GARH M/GARH Arti w/o Inder Raj 27 BC illetrate
M/GARH M/GARH Suman w/o Pankaj vashishth 35 GEN graduation
Anganwadis for Equality: Accelerating Women Empowerment in Haryana Campaign
Data collection Format for Pregnant Women for the Month of August
Contact No. of Skill or Interest of Mother (painting 1st Born Child 2nd Born Child
Mother tailoring, typing, designing, handicraft,
basic computers, pottery, driving,
embroidery, waste material, food articles,
or any other non-traditional skill)
NAME M/F NAME M/F
8307554151 Household work pregnent no
9466175988 Teaching Daksh M Shanvi F
9416117646 Dancing baby of prachi F no
8607946403 Teaching Chirag M Ayansh M
7988662015 Dancing Nitin M Monika F
9053032602 Typing Siddhi Sharma F Saumya SharF
3rd Born Child 4th Born Child 5th Born Child Abortion/ Pregnancy Status as Date of
Miscarriage 31st August, 2023 Registeration
with number of weeks
pregnancy
NAME M/F NAME M/F Name M/F (Yes/no)
no no no no 20 week 10/7/2023
no no no no 31-10-2022
no no no no 7/12/2022
no no no miscarriage 7/12/2022
BABY OF AARTI M no no no 20-04-2023
BABY OF SUMANM no no no 24-04-2023
