National Population Census 2001
[Nepal]
V.D.C./Municipality: ____
Ward: ____
House number: ____
Household number: ____
Total persons: ____
Male: ____
Female: ____
Household and individuals should be enumerated on the basis of their usual place of residence. The question in this schedule should be asked to the Household head or to a HH member who is able to answer the questions. Answers should be marked by circling the number corresponding to the appropriate answer. The response to open-ended questions should precisely be written in words within the space provided. If the option is "others" then encircle the code and specify in words.
[] 2 Semi permanent
[] 3 Temporary
[] 4 Others ____
[] 2 Rented
[] 3 Others ____
[] 2 No (skip to question 5)
4. What is the area of agricultural land holding?
Area
Kattha ____
Dhur ____
Ropani ____
Aana ____
Paisa ____
[] 2 No (skip to question 7)
[] 1 Total livestock: ____
[] 2 Total poultry: ____
[] 2 No
[] 2 No
Kattha ____
Dhur ____
Ropani ____
Aana ____
Paisa ____
[] 2 Small heads ____
[] 2 No (skip to question 11)
[] 1 Small/cottage industry
[] 2 Business/trade
[] 3 Transport
[] 4 Service
[] 5 Others ____
[] 2 No (skip to Individual Information)
[] 3 Don't know (skip to Individual Information)
Sex
[] 2 Female
Duration absent (years) ____
[] 2 Business
[] 3 HH service
[] 4 Institutional service
[] 5 Study
[] 6 Marriage
[] 7 Others
2. Full name of all members of the household
(The head of the household should be recorded first followed by other members of the household serially without missing anybody)
[] 1 Male
[] 2 Female
____
____
[] 1 Head
[] 2 Spouse
[] 3 Son/daughter
[] 4 Daughter-in-law
[] 5 Parents
[] 6 Other ____
[] 1 Hindu
[] 2 Boudha
[] 3 Islam
[] 4 Kirat
[] 5 Jain
[] 6 Isai (Christian)
[] 7 Others ____
1. Mother tongue ____
2. Second language ____
[] 1 Nepali
[] 2 Indian
[] 3 Chinese
[] 4 Other ____
[] 1 Physically disabled
[] 2 Blind
[] 3 Deaf
[] 4 Mentally retarded
[] 5 Multiple disability
[] 6 Not disabled
National Population
Census 2001
District: ____
V.D.C./Municipality: ____
Ward Number: ____
House number: ____
Household number of Form 1: ____
Total persons: ____
[] 2 Well
[] 3 Tube well
[] 4 Spout water
[] 5 River/stream
[] 6 Other ____
[] 2 Kerosene
[] 3 Gas
[] 4 Biogas
[] 5 Goraha/guitha
[] 6. Other ____
[] 2 Kerosene
[] 3 Biogas
[] 4 Other ____
[] 2 Ordinary
[] 3 No toilet
[] 2 TV
[] 3 Cycle
[] 4 Motor
[] 5 Motorcycle
[] 6 Other vehicle
[] 7 Refrigerator
[] 8 Telephone
[] 9 Nothing mentioned above
[] 2 No (go to Individual Information)
[Question 7 was asked of households that had deaths in the household during the last 12 months, per question 6.]
[] 2 Female
Month ____
2. Full name of all the household members (copy all names of the members of HH from Form 1 and circle the sex code 1 for male and 2 for female ________
[] 2 Female
[] 1 Same district (skip to question 7)
[] 2 Other district ____
ii. Municipality ____
[Questions 5 and 6 were asked of persons whose district of birth is different from the present district of residence, per question 4.]
____
[] 2 Agriculture
[] 3 Service
[] 4 Study
[] 5 Marriage
[] 6 Others ____
[] 1 Same district
[] 2 Other district ____
ii. Municipality ____
[Questions 8-10 are asked of persons who are aged 6 years and above.]
[] 1 Read only (skip to column 10)
[] 2 Read and write
[] 3 Illiterate (skip to column 10)
[Question 9 was asked of persons who can read and write, per question 8.]
1. Level passed: ____
2. Field of study for above SLC: ____
[] 1 Yes
[] 2 No
Only for persons aged 10 years and above
[] 1 Never married (skip to column 15)
[] 2 Once married/single spouse
[] 3 Married/multiple spouse
[] 4 Re-married
[] 5 Widow/widower
[] 6 Divorced
[] 7 Separated
(Completed age at the time of the first marriage must be given)
____
[Questions 13 and 14 were asked of only married women age 15-49 years.]
(State all children live born by sex)
Daughter ____
Daughter ____
[] 2 No
[] 2 Salary/wage
[] 3 Own economic enterprise
[] 4 Extended economic work
[] 5 Job seeker
[] 6 Household work
[] 7 Student
[] 8 No work
[] 1 Work done for _ _ (months)
[] 2 Extended economic activity _ _ (months)
[] 3 Work seeking _ _ (months)
[] 4. No work _ _ (months)
____
____
[] 2 Employee
[] 3 Own account worker
[] 4 Unpaid family worker
[] 2 House work
[] 3 Aged
[] 4 Pension
[] 5 Physically and mentally handicapped
[] 7 Sickness or chronic illness
[] 6 Others ____
(Encircle one of the appropriate codes for children less than 16 years)
[] 1 Mother/father
[] 2 Mother
[] 3 Father
[] 4 Father and step mother
[] 5 Mother and step father
[] 6 Other relative
[] 7 House servant
[] 8 Others ____