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    *Acknowledgement

    I. Introduction

    II. General & Specific Objectives

    III. Significance of the study

    IV. Scope & Limitation

    V. Methodology

    VI. Operational Definitions

    VII.Brief Background of Community

    A. Description of the Community

    B. Spot Map

    VIII. Demographic Data

    A. Total Population, Family, Family Surveyed

    B. Population Pyramid

    C. Types of Family Structure

    D. Civil Status

    E. Religion

    F. Length of Residency

    G. Place of Origin

    H. Ethnic Background

    IX. Socio-Economic and Cultural Data

    A. Highest Educational Attainment

    B. Status of Education

    C. Number/Percentage of OSY

    D. Literacy Rate: Education

    E. Status of Employment

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    F. Place of Work

    G. Other Sources of Income

    H. Adequacy of Income Compared to Expenses

    I. Prioritization (Expenditure)

    J. Resources Allotted to Health Care

    K. Land & House Ownership

    L. Type of Construction Materials

    M. Adequacy of Living Space

    N. Adequacy of Ventilation

    O. Food Sanitation

    a. Preparation

    b. Storage

    c. Methods of Cooking

    P. Water Facilities

    a. Type of source

    b. Storage of Water

    c. Water Sanitation

    d. Altitude & Distance From Toilet Facility

    Q. Garbage Disposal System

    R. Toilet Facilities

    a. Type

    b. Condition (if open drainage or not)

    S. Vectors

    a. Type of Vectors

    b. Breeding Sites

    c. Interventions

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    T. Domestic Animals

    a. Kept

    b. Vaccinated

    U. Cultural Beliefs & Practices

    a. Religion, Place of Origin, Primary Dialect Spoken

    X. Health And Illness Patterns

    a. Health Center Communication System

    i. Organizational Chart

    ii. Referral System

    iii. Information Dissemination System

    b. Health Center Program

    c. Maternal and Child Care

    i. Immunization

    ii. Nutritional Status of Children

    iii. Utilization of Family Planning Methods

    iv. Number of Pregnant Women

    v. Prenatal Care

    vi. Tetanus Toxoid

    vii. Breastfeeding

    viii. Bottlefeeding

    d. Health Resources

    i. Manpower

    ii. Categories of Health Services

    e. Leading Causes of Morbidity

    i. Top 5 Based on CST and RR

    ii. Diagnosed and Undiagnosed

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