Schedule – 6
(Related to Rule 25)
Government of Nepal
…………………………… National Park
Format of the List
S.N.:–
1. Name of the Village :–
2. Village Development Committee and Ward :–
3. Name of the Family Head :–
4. Number of Family Members :–
(A) Above Twelve years in Age (Male) : ………………………….
(Female) ………………………….
(B) Up to Twelve years in Age (Male) : ………………………….
(Female) ………………………….
5. Domestic Animals :–
Type or Species of Animals Male Number Female Number Total
Yak, Nak – – –
Sheep, Chyangra – – –
Goat (Boka, Bakhra) – – –
Cow, Oxen (Goru) – – –
Buffalo (Bhaisi, Ranga) – – –
Horse (Ghoda) and Mule (Khachchar) – – –
Duck, Chicken (Kukhura) and
other birds – – –
Dog – – –
Cat – – –
Other Animals – – –
6. House :–
No. of Flats (Talla) : …………………
Wall (Wood, Stone, Brick or other) :– …………….
Roof (Wood, Stone, Gyalvanized sheet (Jasta), Tin or other) :– …………..
Chimni (Available or not) :– ……………….
Other details (If any) :– ……………….
7. Fields (land) :–
Details of field whether Khet, Bari, Goth or Khark etc. :–
Area of Khet, Bari, Khark other (Separately) :–
8. Miscellaneous :–
Estimated Quantity of Firewood required annually (per man load) :– ……
Wood required for the maintenance of the house (Cubic feet) :– ………..
Estimated Area required for pasturing :– ………………………………………
List collecting officer’s,–

Name :– ………………………………….
Signature : – …………………………….
Designation :– ………………………….
Date :– ……………………………………..