Register – India Migration

Register

Name*

Age*

Gender*

Source Address*

Source District*

Source State*

Destination Address*

Destination District*

Destination State*

Mobile*

Adhaar No*

Are You Came?*

Have you check COVID – 19 test?

Have you isolation after COVID – 19 test?

Type of Industry*

Salary*

Have you come along with?

Recruitment through

Have you received Advance from the Company / Contractor?

If Yes, How Much

Do you live with your Family with Children?

If Yes, How Many

Are they going School

If you live with Group of Workers, How Many

Housing Facility*

If Rented Paid by*

Are you Register in Interstate Migrant Govt.Portal?*

If Yes through Whom?

Are you Availed with Medical Facilities? *

If Yes, Please Specify

Are you under PF Scheme?*

Are you under ESI Scheme?*

Deduction in Salary*

Awareness on Wage*

Mode of travel*

Have you Registered in*

Do you have any Pending salary /PF/ESI?*

What is the reason to return back to destination state?*

What are the schemes you have accessed in the destination state?*

What do you expectation? *

Do you have Awarness on Helpline?*

If Yes

Respondent Name

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