1. Personal Details

2. Did you feel the earthquake?

3. Where were you?

4. Indoors or Outdoors?

5. Floor level?

6. What were you doing?

7. Your reaction?

8. Difficulty in standing/walking?

9. Intensity of shaking

10. Any sound heard?

11. Duration

12. Direction

13. Indoor effects

14. House type

15. Outdoor effects

16. Additional Experience