Republic of Ghana
1984 Population Census
Enumeration area No. _ _ _ _ _ _ _ _
Detailed address of house/compound ________
Name of town/village ____
Town/village code (for office use) _ _ _ _ _ _ _ _
Serial No. of house/compound within E.A. _ _ _
Serial No. of household within house _ _
Type of residence code (for office use) _
Socio-economic code (for office use) _ _
Household pattern (for office use) _ _
Date enumeration started in household ____
List A. Usual members present on census night
Serial No. _
Full name ________
Sex _
Relationship to head of household ____
Total number of persons in the house/compound _ _ _
Total number of persons on list A _ _
List B. Visitors present on census night
Serial No. _
Full name ________
Sex _
Relationship to head of household ____
Usual residence
____ Region
Total number of persons on list B _
Total number of persons on lists A and B _ _ _ _
List C. Usual members absent on census night
Serial No. _
Full name ________
Sex _
Age _ _
Relationship to head of household ____
Address on census night
____ Region/country
How long absent? (in completed months) ____
Total number of persons on list C _ _
Lists of relationships to be specified
Temporary head
Wife/husband
Son
Daughter
Father/mother
Father's brother/sister
Mother's brother/sister
Father's father/mother
Mother's father/mother
Brother
Sister
Brother's son/daughter
Sister's son/daughter
Son's son/daughter
Daughter's son/daughter
(Other specify)
Date enumeration completed in household ____
Fill this questionnaire for all usual members and visitors who spent census night in the household (list A and list B)
Make a cross in the appropriate box of write the answer on the dotted line or in the space provided
Answer for each person
[Questions 1-6 were asked of all persons]
1 [] Male
3 [] Female
00 [] In this town/village
[] In another town/village in Ghana
00 [] Ghanaian
[] If not Ghanaian, specify country ____
Answer only for persons aged 5 years and over
[Question 7 was asked of persons age 5 and older.]
1 [] Now
3 [] Past
1 [] Primary _
2 [] Middle _
3 [] Secondary _
[] Other, specify No. of years ____
Answer only for persons aged 10 years and over, the answers should, except where otherwise stated, refer to the seven days before census night
[Questions 8-11 were asked of persons age 10 and older.]
[] No
3 [] Unemployed
4 [] Homemaker
5 [] Student
[] Other, specify ____
[] Number ____
Answer only for the employed (including those with jobs who did not work) and the unemployed
[Questions 9-11 were asked of employed and unemployed persons age 10 and older]
____ Address
2 [] Self-employed without employees
3 [] Self-employed and employs others
4 [] Unpaid family worker
[] Other, specify ____
Enumeration area No. _ _ _ _ _ _ _ _
Name of institution ____
Detailed address of institution or location of outdoor sleepers ________
Name of town/village ____
Town/village code (for office use) _ _ _ _ _ _ _ _
Serial No. of house or location of outdoor sleepers within the E.A. _ _ _
Sex of persons (write 1 for male, 3 for female and 5 for mixed) _
Type of residence code (for office use) _
Socio-economic code (for office use) _ _
For office use S [] KI [] P []
Total number of persons enumerated _ _ _ _
Fill this questionnaire for all the inmates who spent census night in the institution or the floating population
Put a cross in the appropriate box of write the answer on the dotted line or in the space provided
Answer for each person
[Questions 1-6 were asked of all persons]
1 [] Male
3 [] Female
00 [] In this town/village
[] In another town/village in Ghana
00 [] Ghanaian
[] If not Ghanaian, specify country ____
Answer only for persons aged 5 years and over
[Question 7 was asked of persons age 5 and older.]
1 [] Now
3 [] Past
1 [] Primary _
2 [] Middle _
3 [] Secondary _
[] Other, specify No. of years ____
Answer only for persons aged 10 years and over, the answers should, except where otherwise stated, refer to the seven days before census night
[Questions 8-11 were asked of persons age 10 and older.]
[] No
3 [] Unemployed
4 [] Homemaker
5 [] Student
[] Other, specify ____
[] Number ____
Answer only for the employed (including those with jobs who did not work) and the unemployed
[Questions 9-11 were asked of employed and unemployed persons age 10 and older]
____ Address
2 [] Self-employed without employees
3 [] Self-employed and employs others
4 [] Unpaid family worker
[] Other, specify ____
Enumeration _ _ _ _ _ _ _ _
Detailed address of house/compound ________
Name of town/village ____
Serial No. of house/compound within E.A. _ _ _
Census serial No. of house/compound within E.A. (for office use) _ _ _
Serial No. of household within house _ _
Census serial No. of household within house (for office use) _ _
Date interviewing started in household ____
List A. Persons present in household on census night and also present on night before interviewer's visit
Serial No. _
Full name ________
Sex _
Relationship to head of household ____
Total number of persons on list A _ _
List B. Persons present in household on census night but absent on night before interviewer's visit
Serial No. _
Full name ________
Address on the night before interviewed
____ Region
Address of usual place of residence
____ Region
Total number of persons on list B _
Total number of persons on lists A and B _ _
List C. Persons absent from household on census night but present on night before interviewer's visit
Serial No. _
Full name _______
Sex _
Age _ _
Relationship to head of household ____
Detailed address of place of stay on census night
House name and compound name, or other description ____
Town/village ____
Region ____
Total number of persons on list C _ _
Date enumeration completed in household ____
Fill this questionnaire for all persons who spent census night in the household (mark a cross in the appropriate box or write the answer on the dotted line or in the space provided)
[Questions 1-5 were asked of all persons]
(1) Full name (and other names) ________
3 [] Female
If employed, what kind of work did you do? If employed, what was your last kind of work?