NEVIS DISASTER MANAGEMENT DEPARTMENT (NDMD)

Initial Damange Assessment Listing Form

Personal Information

Head of Household

Household Information
No. of Adults in Household
No. of Children (under 18) in Household
No. of Infants in Household
No. of Disabled Adults
No. of Disabled Children (under 18)
No. of Disabled Infants
Indicate Damage to the Main Elements of the Structure
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