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Republic of Kenya

Population Census
1969

Enumeration area number _ _ _ _ _ _ _ _

"B" Schedule.

a. Name: ____

b. Relationship: ____

c. Tribe or nationality: ____ _ _

For Kenya Africans state tribe.
For others, state race, country of citizenship.

d. Sex: _

(Write M for males and F for females.)

e. Age: _ _

(State age in completed years.)

f. Birth place: ____ _ _

If born in district where enumerated, write "here".
If born elsewhere in Kenya, state district.
If born outside Kenya, state country.

g. Marital status: ____ _

(State whether single, married, widowed, divorced or separated.)

h. Education: ____ _ _

(State highest standard or form completed.)

i. Is father alive? ____ _

(Answer yes or no.)

j. Is mother alive? ____ _

(Answer yes or no.)

To be asked of females aged 12 and over only
[Questions k-o were asked of females aged 12 and over.]

Of the children you have ever borne alive:

k. How many are now living with you? ____

l. How many are now living elsewhere? ____

m. How many have died? ____

Date of the last live birth:

n. Year ____

o. Month ____