Appendix 1The Census schedule____ Province____ District____ Division____ Location____ Sub-location____ E.A. number____ Household number
For all persons
a. Name: ____
b. Relationship: ____What is the relationship of this person to the head or other members of the household?
c. Sex: _Write M for males or F for females.
d. Age: ____How old was this person at his or her last birthday?
e. Tribe or nationality: ____State tribe for Kenya Africans, race or other Kenyans, nationality for non-Kenyans.
f. Birthplace: ____Where was this person born? State district if born in Kenya or country if born outside Kenya.
g. Previous residence: ____Where was this person living in August 1978? State district if in Kenya or country if outside Kenya.
h. Education: School attendance ____State whether currently attending school, ever attended school or never attended school
[If the person has been to school or is at school]i. Education: ____What was/is the highest class or form reached?
j. Is his or her father alive? ____Write yes or no
k. Is his or her mother alive? ____Write yes or no
l. Marital status: ____State whether single, married, widowed, divorced, or separated.
For all females aged 12 years and older
How many children has this woman given birth to, who were born alive and are now living in this household?m. Boys ____n. Girls ____
How many children has this woman given birth to, who were born alive and are now living elsewhere?o. Boys____p. Girls ____
How many children has this woman given birth to, who were born alive and who have died?q. Boys ____r. Girls ____
Particulars of her last birth:
When was her last child borne?s. Year ____t. Month ____u. Was it a boy or a girl? _Write M or F
National Institutes of Health,
National Science Foundation,
University of Minnesota.
Copyright © Minnesota Population Center, University of Minnesota.