Bangladesh Bureau of Statistics
Population and Housing Census 2001
Short Questionnaire
Form-01/PC-2001
1 Part of previous household? _
2 Address ____
3 Household number _ _ _
6. Is this a tribal household? _
7. Household type
[] 2 Institutional
[] 3 Others
8. Number of structure of Household
("9" if part of the household and "0" otherwise)
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8
[] 9
9. Household types of main house
[] 2 Katcha
[] 3 Semi Pucca
[] 4 Pucca
10. Ownership of house
[] 2 Rented
[] 3 Rent-free
11 Source of drinking water
[] 2 Tube well
[] 3 Deep tube well
[] 4 Pond/tank
[] 5 Others
12 Toilet facilities
[] 2 Others
[] 3 None
13 Electricity connection
[] 2 No
14 Own agriculture land
[] 2 No
15 Has disabled persons?
(Check ?Yes if the household has disabled persons)
[] Yes
[] No
[] 1
[] 2
[] 3
[] 1
[] 2
[] 3+
[] 1
[] 2
[] 3
[] 4+
[] 1
[] 2
[] 3+
16. Main source of income of the household
[] 2 Fisherman/Fish farming
[] 3 Agriculture labor
[] 4 Non-Agriculture labor
[] 5 Handloom
[] 6 Industry/Factory
[] 7 Business
[] 8 Hawker
[] 9 Transport
[] 10 Construction
[] 11 Religious work
[] 12 Service
[] 13 Rent
[] 14 Remittance
[] 15 Others
17. Name of the members of the Household
(Starting with the name of the head of the household)
Serial number _ _
Name ____
18. Age (in complete years)
(Written the age by verifying with others)
Age _ _
19. Relationship to the head of the household
[] 2 Wife/husband
[] 3 Children
[] 4 Others
21 Marital status
[] 2 Married
[] 3 Widow/widower
[] 4 Divorced/Separated
22 Religion
[] 2 Hindu
[] 3 Christian
[] 4 Buddhist
[] 5 Others
[Questions from 23 to 28 is applicable for persons aged 5 years and above]
23 Highest grade passed
[] 1 Class I
[] 2 Class II
[] 3 Class III
[] 4 Class IV
[] 5 Class V
[] 6 Class VI
[] 7 Class VII
[] 8 Class VIII
[] 9 Class IX
[] 10 Secondary school certificate (SSC)/ Dakhil
[] 11 Training
[] 12 Higher secondary certificate (HSC)/ Alim
[] 13 Diploma
[] 14 Bachelor/ Fazil
[] 15 Bachelor honors
[] 16 Master/ Kamil
[] 17 Master (MS)/ Phd.
24 Field of education
[] 2 Vocational/Technical
[] 3 Religious
26. Can write a letter?
[] 2 No
27. Main field of Profession/work (last one week)
[] 2 Looking for work
[] 3 Household work
[] 4 Agriculture
[] 5 Industry
[] 6 Water/Electricity/Gas
[] 7 Construction
[] 8 Transport/communication
[] 9 Hotel/restaurant
[] 10 Business
[] 11 Service
[] 12 Others
28. Work status
[] 2 Family worker
[] 3 Self-employed
[] 4 Day labor
[] 5 Servant at home
[] 6. Others