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National Population Census 2001
[Nepal]

Schedule 1

District: ____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.

Household information

1. What is the type of the house occupied by the household?

[] 1 Permanent
[] 2 Semi permanent
[] 3 Temporary
[] 4 Others ____

2. What is the type of ownership of the house occupied by the HH?

[] 1 Owned
[] 2 Rented
[] 3 Others ____

3. Is agricultural land holding possessed by the household (HH)?

[] 1 Yes
[] 2 No (skip to question 5)

4. What is the area of agricultural land holding?

[Question 4 was asked of households that had agricultural land, per question 3.]

Area
Bigha ____
Kattha ____
Dhur ____

Ropani ____
Aana ____
Paisa ____

5. Does your household raise livestock/poultry?

[] 1 Yes
[] 2 No (skip to question 7)

6. How many?

[Question 6 was asked of households that raised livestock/poultry, per question 5.]

[] 1 Total livestock: ____
[] 2 Total poultry: ____

7. Does female member of HH own any of the following property?

1 House
[] 1 Yes
[] 2 No

2. Land
[] 1 Yes (specify)
[] 2 No
Area
Bigha ____
Kattha ____
Dhur ____

Ropani ____
Aana ____
Paisa ____

8. Do female members of HH personally own any livestock/cattle?

[] 1 Yes (specify)
[] 1 Big heads ____
[] 2 Small heads ____
[] 2 No

9. Is your HH engaged in small scale economic activities other than agriculture?

[] 1 Yes
[] 2 No (skip to question 11)

10. Which is the main activity?

[Question 10 was asked of households that engaged in small scale economic activities other that agriculture, per question 9.]

[] 1 Small/cottage industry
[] 2 Business/trade
[] 3 Transport
[] 4 Service
[] 5 Others ____

11. Are any persons absent from the household living in other countries?

[] 1 Yes (go to question 12)
[] 2 No (skip to Individual Information)
[] 3 Don't know (skip to Individual Information)

12. Give description of persons absent and living in other countries:

[Question 12 was asked of households that had persons absent from the household who were living in other countries, per question 11.]

Sex
[] 1 Male
[] 2 Female

Age when left home (years) ____
Duration absent (years) ____

Reason absent
[] 1 Agriculture
[] 2 Business
[] 3 HH service
[] 4 Institutional service
[] 5 Study
[] 6 Marriage
[] 7 Others
Destination country ____

Schedule 1

1. S.N. _ _

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)

3. What is ____ sex?

(For males code 1 and for females code 2 must be encircled)

[] 1 Male
[] 2 Female

4. What is ____ age?

(Completed age must be given and 00 for age less than a year)
____

5. What is ____ caste/ethnicity?

(Caste of the individual person should be written).
____

6. What is ____ relation to head of the HH?

(Codes must be encircled which denote appropriate relation)

[] 1 Head
[] 2 Spouse
[] 3 Son/daughter
[] 4 Daughter-in-law
[] 5 Parents
[] 6 Other ____

7. What is ____ religion?

(Codes must be encircled according to the religion practiced)

[] 1 Hindu
[] 2 Boudha
[] 3 Islam
[] 4 Kirat
[] 5 Jain
[] 6 Isai (Christian)
[] 7 Others ____

8. What is ____ spoken language?

(Mother tongue must be specified in code "1" and second language in code "2")

1. Mother tongue ____
2. Second language ____

9. What is ____ citizenship?

(Citizenship as to the country must be circled and specified for others)

[] 1 Nepali
[] 2 Indian
[] 3 Chinese
[] 4 Other ____

10. What is ____ type of disability?

(Codes must be encircled which denote appropriate disable)

[] 1 Physically disabled
[] 2 Blind
[] 3 Deaf
[] 4 Mentally retarded
[] 5 Multiple disability
[] 6 Not disabled

National Population
Census 2001

Schedule 2

District: ____
V.D.C./Municipality: ____
Ward Number: ____
House number: ____
Household number of Form 1: ____
Total persons: ____

1. What is the main source of drinking water for this household?

[] 1 Tap (pipe)
[] 2 Well
[] 3 Tube well
[] 4 Spout water
[] 5 River/stream
[] 6 Other ____

2. What fuel do you usually use for cooking?

[] 1 Wood
[] 2 Kerosene
[] 3 Gas
[] 4 Biogas
[] 5 Goraha/guitha
[] 6. Other ____

3. What fuel do you usually use for lighting?

[] 1 Electricity
[] 2 Kerosene
[] 3 Biogas
[] 4 Other ____

4. What is the type of toilet used by this household (HH)?

[] 1. Flush/modern
[] 2 Ordinary
[] 3 No toilet

5. What type of facilities does this HH possess?

[] 1 Radio
[] 2 TV
[] 3 Cycle
[] 4 Motor
[] 5 Motorcycle
[] 6 Other vehicle
[] 7 Refrigerator
[] 8 Telephone
[] 9 Nothing mentioned above

6. During the last 12 months was there any deaths occurred in this HH?

[] 1 Yes
[] 2 No (go to Individual Information)

7. If yes, give the description of deceased persons.[Question 7 was asked of households that had deaths in the household during the last 12 months, per question 6.]

Sex
[] 1 Male
[] 2 Female
Age ____
Date when died
Year ____
Month ____
Cause of death ____
Individual information

1. Serial number

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 ________

[] 1 Male
[] 2 Female

3. Age (copy from form 1) _ _

4. Where is ____ place of birth?

(Code must be encircled, if the place of birth is other district or other country the name must be specified)

[] 1 Same district (skip to question 7)
[] 2 Other district ____
i. VDC ____
ii. Municipality ____
[] 3 Other countries ____

Only for code 2 and 3 in question 4[Questions 5 and 6 were asked of persons whose district of birth is different from the present district of residence, per question 4.]

5. What is ____ duration of stay here?

(Completed years must be given: 00 for less than 1 year)
____

6. What is ____ main reason for staying in this district?

[] 1 Business/trade
[] 2 Agriculture
[] 3 Service
[] 4 Study
[] 5 Marriage
[] 6 Others ____

7. Where were ____ living 5 years before?

[Only for persons 5 years and above]

[] 1 Same district
[] 2 Other district ____
i. VDC ____
ii. Municipality ____
[] 3 Other countries ____

Only for persons aged 6 years and above[Questions 8-10 are asked of persons who are aged 6 years and above.]

8. Can ____ read and write?

(If read only 1, if read and write 2, and if illiterate 3)

[] 1 Read only (skip to column 10)
[] 2 Read and write
[] 3 Illiterate (skip to column 10)

9. What is ____ level of education passed?

(Only code 2 in column 8)
[Question 9 was asked of persons who can read and write, per question 8.]

1. Level passed: ____

2. Field of study for above SLC: ____

10. Is ____ currently attending school?

(For those aged less than 25 years and who have not passed class 10)

[] 1 Yes
[] 2 No

11. What is ____ marital status?

(Codes must be encircled according to the marital status of the person)
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

12. What was ____ age at first marriage?

[Question 12 was asked of ever married persons, per question 11.]

(Completed age at the time of the first marriage must be given)

____

Only for married women (15-49 year of age)[Questions 13 and 14 were asked of only married women age 15-49 years.]

13. How many children were ever born to ____? (State all children live born by sex)

1. Living together
Son ____
Daughter ____

2. Living separately
Son ____
Daughter ____

3. Dead
Son ____
Daughter ____

4. Total
Son ____
Daughter ____

14. Has ____ had any live births during the last 12 months?

[] 1 Yes
[] 2 No

[If yes]

Sex
[] 1 Male
[] 2 Female

Year _ _ _ _
Month _ _

Questions [15 to 20] are asked to persons 10 years of age and above

15. What work ____ usually doing during the last 12 months?

[] 1 Agriculture
[] 2 Salary/wage
[] 3 Own economic enterprise
[] 4 Extended economic work
[] 5 Job seeker
[] 6 Household work
[] 7 Student
[] 8 No work

16. How many months did ____ work during the last 12 months?

(Specify approx. the number of months spent in each category)

[] 1 Work done for _ _ (months)
[] 2 Extended economic activity _ _ (months)
[] 3 Work seeking _ _ (months)
[] 4. No work _ _ (months)

Total 12 months

17. What work ____ usually do? (Occupation)

(Describe the actual work done)

____

18. Where did ____ do the work? (Industry)

(Name the establishment or the organization where worked)

____

19. What was ____ employment status?

[] 1 Employer
[] 2 Employee
[] 3 Own account worker
[] 4 Unpaid family worker

20. What was the ____ reason for usually not working during the last 12 months?

[] 1 Student
[] 2 House work
[] 3 Aged
[] 4 Pension
[] 5 Physically and mentally handicapped
[] 7 Sickness or chronic illness
[] 6 Others ____

21. Which of the following living arrangement does ____ adopt?

Only for children below 16 years of age

(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 ____