REPUBLIQUE DU CAMEROUN REPUBLIC OF CAMEROON

Paix –Travail – Patrie Peace – Work – Fatherland

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REGION DU CENTRE CENTER REGION
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DELEGATION REGIONALE DES AFFAIRES REGIONAL DELEGATION OF SOCIAL
SOCIALES AFFAIRS
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DELEGATION DEPARTEMENTALE DES AFFAIRES DIVISIONAL DELEGATION OF SOCIAL
SOCIALES DU MFOUNDI AFFAIRS FOR MFOUNDI
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CENTRE SOCIAL DE YAOUNDE V- ESSOS SOCIAL CENTER OF YAOUNDE V

N°2023/ /RES/RC/DRAS/DDAS-MFDI/CESO-YDE V

RAPPORT D’ENQUETE SOCIALE

Concernant

Object :

I - IDENTIFICATION :

Nom et prénom : _________________________________________________________

Date et lieu de naissance : __________________________________________________
Région d’origine :_________________________________________________________
Département :____________________________________________________________
Arrondissement : _________________________________________________________
Ethnie :__________________________________________________________________
Niveau d’études : __________________________________________________________
Profession :______________________________________________________________
Religion : _______________________________________________________________
Situation matrimoniale : ___________________________________________________
Antécédents judiciaires : ___________________________________________________
Antécédents médicaux :____________________________________________________
Résidence :______________________________________________________________
Adresse :______________________________________________________________
 II – COMPOSITION DE LA FAMILLE
A - Parents :

Père :
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Mère : ________________________________________________________________
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b – Conjoint :
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c – Progéniture
N° NOMS ET Age Situation Profession Lieu de

PRENOMS matrimoniale résidence

01

02

03

04

05

06

07

08

09

10

11
d-Fratrie :
N° NOMS ET Age Situation Profession Lieu de

PRENOMS matrimoniale résidence

01

02

03

04

05

06

07

08

09

10

11

III – CONDITIONS MATERIELLES ET FINANCIERES

a – CONDITIONS MATERIELLES
- Cadre de vie
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- L’environnement
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b – Conditions financières
- Ressources

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- Les charges

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IV - HISTOIRE DE VIE DE L’INTERESSE (E)

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Situations problèmes :

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V - ANALYSE ET SUGGESTIONS
A) ANALYSE
Sur le plan physique
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Sur le plan familial et social

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 Sur le plan psychologique

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Sur le plan matériel et financier

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Sur le plan sanitaire

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Sur le plan juridique

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B) SUGGESTIONS

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Le Chef de Centre L’Enquêteur