[Burkina Faso 1985]
Census Questionnaire (household sheet)
Concession _ _ _
Household _ _
Sheet number _
Number of sheets _
Nationality of head of household ____
Language fluently spoken in the household ____
Deaths in the last 12 months
[] Yes
First and last name of deceased ____
Sex of deceased ____
Age at death ____
Household summary
Present residents
Female _
Total _
Absent residents
Female _
Total _
Emigrants
Female _
Total _
Visitors
Female _
Total _
Total males _
Total females_
Household total _
All persons
[Questions 1-8 were asked for all persons.]
4. Relationship to household head ____
6. Age or date of birth
____ Date of birth
8. Place of residence one year ago ____
Residents 10 years of age and older
[Questions 9-15 were asked for residents age 10 and older.]
9. Knows how to read and write (in which language) ____
13. Employment situation in principal occupation ____
15. Employment situation in secondary occupation ____
Residents 12 years of age and older
[Questions 16-20 were asked for residents age 12 and older.]
Women only
[Questions 17-20 were asked for females age 12 and older.]
17. Total number of children born alive ____
18. Total number of children still alive ____
Births in the last 12 months
20. Female _ _
Handicap
[Question 21 was asked of all persons.]
21. Type of handicap ____