1. Has any member of the Household been affected YES/NO physically by the floods or the landslides . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. If “YES” state the nature of disablement: . , . . . . . . . . . . . Sex: . . . , Age: . . . . Number: . . . . . 5) Loss of human life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii) Physically hadicapped . . . . . . . . . . , . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3, Give details about the mishap: . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Has the Household experienced any loss in YES/NO 
**Analysis**
This text appears to be a survey or report related to the impact of natural disasters, specifically floods and landslides, on households. The questions focus on the physical effects on household members, loss of life, and disablement, which suggests a humanitarian aid and relief context.

**Category**
Humanitarian aid and relief