For Indian households only
What language do the members of this household speak amongst themselves?
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]
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
____
4. Age in completed years.
____
5. For females aged 15 years or older
____ Total number of children still living
____ Age when first child born
[Questions 6-10 were asked of all persons.]
6. Marital status
M-Married
W-Widowed
D-Divorced
____
7. Place of birth
If born outside Fiji, name of country or island group
____
8. Date of birth
____
9. Is [the respondent] Chinese or Part-Chinese, European, Fijian, Indian, Part-European, Rotuman, Samoan, Tongan, etc.?
10. Religion
____
11. Education
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
____ Females
____ Total
For the purposes of reproduction in this report this form has been reduced in size.