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Questionnaire of the
Third National Population Census
1982
State Statistical Bureau of The People's Republic Of China

____ Household Address
____ Province, Municipality, Autonomous Region
____ County, City
____ Commune, Street Committee
____ Production Brigade, Residents' Committee
____ Production Team, Presidents' Group (Street ____, Lane ____ No. )
____ Name of Collective Household

Reference Time: 00:00 a.m. July 1, 1982
Respondents must provide information honestly
Enumerators must record the answers accurately

I. Household Type

[] 1. Domestic HH.
[] 2. Collective HH.

II. Serial No. of the household

_ _ _

No. of persons in the household

____ Total
____ Male
____ Female
_ _ _

IV. No. of births in the household in 1981

____ Total
____ Male
____ Female
_ _

V. No. of deaths in the household in 1981

____ Total
____ Male
____ Female
_ _

VI. No. of registered persons absent over one year

____ Total
____ Male
____ Female
_ _ _

Attachment: Registered person absent above one year

[Space for four persons provided]

____ Name
____ Sex

Remarks: ____
[The questions are displayed in a table. The columns contain the questions and the rows space for the answers of five persons]

Each Person
[Applies to questions I - VI]

I. Name

____
3 _ _

II. Relationship to head of household

[] 1. Head of household
[] 2. Spouse
[] 3. Child
[] 4. Grandchild
[] 5. Parent
[] 6. Grandparent
[] 7. Other relative
[] 8. Other non-relative

III. Sex

[] 1. Male
[] 2. Female

IV. Age

Date of birth
____ Year
____ Month
____ Day
____ Years of Age
_ _ _

V. Nationality

____
_ _

VI. Registration Status

[] 1. Residing and registered here
[] 2. Residing here over 1 year but registered elsewhere
[] 3. Residing here less than 1 year absent from the registration place over 1 year
[] 4. Living here with registration unsettled
[] 5. Used to reside here; is abroad with no registration

Persons aged 6 and above
VII. Educational level

[] 1. College graduate
[] 2. Undergraduate
[] 3 Senior middle school
[] 4. Junior middle school
[] 5. Primary school
[] 6. Illiterate or semi-literate

Persons aged 15 and above
[Applies to questions VIII - XI]

VIII. Industry

____
_ _ _

IX. Occupation

____
_ _ _

X. Status of non-working person

[] 1. Student
[] 2. Housekeeping
[] 3. Awaiting school enrollment
[] 4. Awaiting state employment
[] 5. Awaiting job assignment in city/town
[] 6. Retired or resigned
[] 7. Other

Marital Status

[] 1. Never Married
[] 2. Married
[] 3. Widowed
[] 4. Divorced

Women aged 15 to 64
XII. No. of children ever born and currently alive

____ Children born alive
____ Children living at present
_ _ _ _

Women of childbearing age - 15 to 49
XIII. Bore the following in 1981

[] 0. No birth
[] 1. First child
[] 2. Second
[] 3. Third
[] 4. Fourth
[] 5. Fifth or more

____ Respondent
____ Enumerator
Date
____ Month
____ Day
____ Head of Household
____ Total Pages
____ Page No.
____ Page in the booklet