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Census of Fiji
12th September, 1966

For Indian households only
What language do the members of this household speak amongst themselves?

1 [ ] Gujerati
2 [ ] Gurmukhi
3 [ ] Hindi
4 [ ] Malayalam
5 [ ] Tamil
6 [ ] Telegu
7 [ ] Urdu
8 [ ] Hindustani
9 [ ] All other

Appendix B
____ Name of island
____ Province
____ Tikina
____ Enumerator's district number
____ Town
____Village
____ Settlement
____ Locality
____ Estate

Household schedule to be completed by the enumerator, listing every man, woman and child in each household at midnight on Monday, 12th September, 1966.
[Questions 1-4 were asked of all persons]

1. Name

Fijians, personal names only
Indians, personal names and father's name
Europeans and others, enter surnames or family name in block letters
____

2. Relationship to head of household such as head, wife, son, daughter, mother, adopted son, son-in-law,visitor, servant, etc.

____

3. Sex

For male write M, for females write F.
____

4. Age in completed years.

If under 1 year write 0
____

5. For females aged 15 years or older

____ Total number of children born
____ Total number of children still living
____ Age when first child born

[Questions 6-10 were asked of all persons.]

6. Marital status

NM-Never married
M-Married
W-Widowed
D-Divorced
____

7. Place of birth

If born in Fiji, name of province;
If born outside Fiji, name of country or island group
____

8. Date of birth

Exact year and, if known month of year
____

9. Is [the respondent] Chinese or Part-Chinese, European, Fijian, Indian, Part-European, Rotuman, Samoan, Tongan, etc.?

____

10. Religion

Exact domination or sect
____

11. Education

For all persons aged 15 years or older
Years at school
____

12. Occupation
What work does [the respondent] do and for whom and where does [the respondent] do it?
[For all persons]

____

Number of persons in this household

____ Males
____ Females
____ Total

For the purposes of reproduction in this report this form has been reduced in size.