Confidential
Form 2
(Enumeration form)
Sheet number _____of _____sheets for this household
Number of persons in this household _ _
Code (for field work use) _ _ _ _ _ _
Code (for office use) _ _ _ _ _ _ _ _
e. Name of place (if any) ______
g. Is this house in a Municipal Area or a Sanitary District?
[] 2. This house is in a Sanitary District (S.D.).
i. Type of household:
Collective household: institutions
[] 3 Jail
[] 4 Welfare lodging
[] 5 Hospital
[] 6 Dormitory/boarding school
[] 7 Military or police barracks
[] 9 Rooming house and other
2. Relationship to head of household:
[] Wife
[] Son/daughter
[] Son-in-law
[] Daughter-in-law
[] Grandchild
[] Father
[] Mother
[] Sibling
[] Nephew/niece
[] Other relative
[] Person who has permanent residence at this domicile, without being a relative, boarder or employee
[] Maid
4. Month and year of birth______
6. Residence status:
[] Temporarily away from home
[] Temporary resident and have no other residence elsewhere
7. Religion:
[] Islam
[] Christian
[] Hindu
[] Other, specify ____
[] None
9. Place of birth (province or country) ______
10. Physical disability (Record "No" if there is no physical disability.) ______
[Questions 11-16 are asked of persons 5 years and over]
11. Length of residence in this village or Municipal Area (Number of years) ______
If recorded fewer than 5 years in question 11, answer questions 12 and 13.
[Questions 12 and 13 are asked of persons age 5+ who lived fewer than 5 years in the present village or Municipal Area, as per question 11.]
12. Place of previous residence (province or country) ______
13. Moved from another village or Municipal Area:
[] M.A.
14. Literacy: can read and write in any language?
[] No
15. School attendance and grade, as of January 1970
[] Attend school: ______ grade
[] Not attend school
[] Attend school but do not know grade
16. Highest grade completed as of 1 January 1970 (e.g. grade 1; grade 7; year in university or in technical institute; "never" if never completed any grade) ______
Only for persons 11 years and over
[Questions 17-24.]
17. Marital status:
[] Married
[] Widowed
[] Divorced
[] Separated
[] Priesthood
Number of children ever born alive:
18. Total born alive ______
19. Still living ______
20. Occupation last week (25 March - 31 March 1970) ______
21. Reason for not working, if record "not working" in 20:
[] Waiting for the agricultural season
[] Doing housework
[] Studying
[] Cannot work because the person is ill, old, or disabled
[] Others, specify ____
22. Occupation last year: ______
[Record the occupation that the person spent most of the time working on during April 1969 - March 1970. If the person did not work, record "not working" and do not ask questions 23 and 24.]
If recorded "working" in question 22, answer questions 23 and 24.
23. Type of industry (e.g. tobacco, movie theatre, school, rice fields, etc.) ______
24. Work status:
[] Self-employed
[] Government employee
[] Private employee
[] Unpaid household worker
For temporary visitors (less than 3 months) with usual residence elsewhere
5. District ______
6. Sub-district ______
7. Village/ Municipal Area ______
8. Who in the family are they visiting?
[] Some persons
Do not ask the collective household.
For Municipal Areas, ask housing questions in all households.
For Non-Municipal Areas, ask housing questions only in households with the letter "B".
(The letter of the 9th column in the "Sor Por Kor 1" form is:
[] A
[] B
[] C
[] D.
If the letter "B" is checked, ask the housing questions. If not, terminate the interview.)
[Approximately 1 in 3 households from Non-Municipal Areas were asked the household questions.]
Questions 25-26. Record either interview from the inspection of the house.
25. Type of structure:
[] 2 Row house
[] 3 Apartment
[] 4 Room
[] 5 Mobile (boat, raft, or car)
[] Others, specify ____
If marked "5" or "Others," terminate the interview.
26. Is this house used for commercial purposes?
[] 2 No
27. Type of construction materials:
[] 2 Wood, cement, brick (mixed)
[] 3 Wood
[] 4 Local materials
[] 5 Old used materials
28. Tenure of house (excluding land):
[] 2 Buy on installment
[] 3 Rent
Live without paying rent because:
[] 5 Free
29. Rent (in Baht) per month, if select "3" [rent] in question 28. ______
30. Ownership of land, if select "1" or "2" [owner or buy or installment] in question 28:
[] 2 Installment buying
[] 3 Rented from government
[] 4 Rented from other
[] 5 Rent free
31. If rent or rent-free in question 28, who is the owner of the house?
[] 2 Government agency
[] 3 Private
[] 1 1 year
[] 2 2 years
[] 3 3 years
[] 4 4 years
[] 5 5-9 years
[] 6 10-14 years
[] 7 15-19 years
[] 8 20+ years
[] 9 Unknown
33. Number of rooms used for sleeping:
Other rooms used for sleeping _____
[] 2 Exclusive use
[] 4 Exclusive use
[] 6 Other or none
[] 2 Wood
[] 3 Gas
[] Other, specify ____
[] 2 Pressure lamp
[] 3 Other oil lamp
[] Other, specify ____
[] 2 Piped water, outside
[] 3 Public well
[] 4 Private well
[] 5 Rain water
[] 6 River, canal, etc.
[] Other, specify ____
[] 2 No
[] 2 No
Buffaloes ______
Pigs ______