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Canal/River/Stream
Groundwater
b) Is there water pollution?
Yes Sources:…………………………………
No
c) Is there is air pollution
Yes Sources:…………………………………
No
d) What are the main sources of food ?
Agriculture
markets
Peddlers
Food shops
e) Is there is food contamination?
Yes Sources:…………………………………
No
f) Is there is a sewerage/drainage system in the village for the disposal of
waste water?
Yes
No
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