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Household Questionnaire for Popstan Census

This document appears to be a census questionnaire used to collect population and housing data in Popstan. It contains questions about individuals' demographic information like name, age, sex, place of birth, as well as questions about households' living conditions including housing type, water/electricity access, and number of rooms. The questionnaire collects data on both population and housing to understand the characteristics of both for census purposes.

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abdulkawimoharram
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48 views1 page

Household Questionnaire for Popstan Census

This document appears to be a census questionnaire used to collect population and housing data in Popstan. It contains questions about individuals' demographic information like name, age, sex, place of birth, as well as questions about households' living conditions including housing type, water/electricity access, and number of rooms. The questionnaire collects data on both population and housing to understand the characteristics of both for census purposes.

Uploaded by

abdulkawimoharram
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Population and Housing Census of Popstan

All information is confidential


Household Section
Province Sheet
District
Village
EA
Housing Unit Number
Total Persons in HH
Total Females in HH
Total Males in HH
W
h
a
t

i
s

(
n
a
m
e
)
's

s
e
x
?
What is
(name)'s
highest
level of
education?
What is
(name)'s
marital
status?
P04 P10 P11
1
2
3
4
5
6
7
8
9
0
P03
What is (name)'s date of
birth?
P02
(If younger
than 12
months,
write 000.
If older than
115 years,
write 115.)
1-Detached home
2-Apartment
3-Other
Conventional
4-Other Collective
(go to question
P01)
What is the occupancy
status of this housing
unit?
1-Occupied
2-Vacant
(end questionnaire)
What is the
principal water
source for
drinking water?
H02 H05
1-Piped, inside unit
2-Piped, outside
unit
3-Well
4-Other
H01
P09
How many
rooms are
in this
housing
unit? (do
not include
kitchen or
bathrooms)
H04
Population Section
What is the
ownership
status?
1-Owner-occupied
2-Employer-owned
3-Government-
owned
4-Other
What is the
type of this
housing unit?
P07
Year
P06a
1-Electric
2-Gas
3-Candle
4-Other
P13
1-Married
2-Separated
3-Divorced
4-Widowed
5-Never
married
1-No Educ
2-Primary
3-Secondary
4-Univ, 2 yr
5-Bachelors
6-Masters
7-Doctorate
Where did (name) live 5 years
ago?
ALL AGES
of
What are the bathing facilities?
1-Bathtub or shower with piped water
for exclusive use by this HU
2-Bathtub or shower with piped water
shared with occupants of another HU
3-Hand basin with piped water
4-Portable tub or basin
5-Other
H06
What is your principal
source of heating?
H09 H08
How many
members of the
household have
died in the last
twelve months?
What is the type of solid
waste disposal?
1-Collected on a regular basis
2-Collected on an irregular basis
3-Occupants dispose of in a
supervised dump
4-Occupants dispose of in an
unsupervised dump
5-Other
1-Electricity
2-Natural Gas
3-Coal or wood
4-Oil or kerosene
5-Other
6-None
What are the
toilet facilities?
1-Flush toilet for
exclusive use by HU
2-Flush toilet share
with another HU
3-Outhouse or
outbuilding
4-Covered pit
5-Open pit
6-Other
H07
1-Popstan
2-Kiribati
3-Vanuatu
4-Tuvalu
5-Other
If (name) lived in Popstan 5 years ago,
write the name of the Popstan Province.
If (name) lived outside of Popstan, write
the name of the country.
What is your
principal
source of
lighting?
What is (name)'s place of
birth?
If (name) was born in Popstan, write
the name of the Popstan Province.
If (name) was born outside of Popstan,
write the name of the country.
How many
children are
still alive?
How many
children has
(name)
given live
birth to?
P16a P16b
M F M F
P15b P14 P08 P15a
What is (name)'s type of
industry or name of
employer?
What is (name)'s
occupation?
What is
(name)'s
citizenship?
P12
WOMEN AGED 15 - 49
What is
(name)'s
age as of
Census
Day?
P
e
r
s
o
n

N
u
m
b
e
r
P01
What is this person's first and last
name?
H03
P06c
Month
1-M
2-F Day
What is
(name)'s
relationship to
the head of the
household?
1-Head
2-Spouse
3-Child
4-Grandchild
5-Parent
6-Other
relative
7-Non-relative
8-Institutional
member
P06b P05
AGES 10 AND OLDER
During this last week was
(name) engaged in any
work activities?
1-Yes
2-No
If no and this person is
female, skip to question
P15a.
If no and this person is
male, go to the next
person.
H11 H10
AGES 5 AND OLDER

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