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Enumeration form: Census of Thailand, 1970

Confidential
Form 2
(Enumeration form)

Sheet number _____of _____sheets for this household

Part 1

Number of persons in this household _ _

Code (for field work use) _ _ _ _ _ _

Code (for office use) _ _ _ _ _ _ _ _

a. Road, lane, canal______

b. House number ______

c. Village number ______

d. ED number ______

e. Name of place (if any) ______

f. Block number ______

g. Is this house in a Municipal Area or a Sanitary District?

[] 1. This house is in a Municipal Area (M.A.).
[] 2. This house is in a Sanitary District (S.D.).
Name of S.D. ______
[] 3. This house is out of M.A. or S.D.

h. Household number ______

i. Type of household:

[] 1 Private household

Collective household: institutions
[] 2 Temple (Wat)
[] 3 Jail
[] 4 Welfare lodging
[] 5 Hospital
[] 6 Dormitory/boarding school
[] 7 Military or police barracks
Other collective household
[] 8 Hotel
[] 9 Rooming house and other

Part 2

For every person

1. Name and surname ______

2. Relationship to head of household:

[] Head
[] 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

3. Sex:

[] Male
[] Female

4. Month and year of birth______

5. Age (in full year) ______

6. Residence status:

[] Permanent resident
[] Temporarily away from home
[] Temporary resident and have no other residence elsewhere

7. Religion:

[] Buddhist
[] Islam
[] Christian
[] Hindu
[] Other, specify ____
[] None

8. Citizenship ______

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:

[] Village
[] M.A.

14. Literacy: can read and write in any language?

[] Yes
[] No

15. School attendance and grade, as of January 1970

(For persons 5-29 years of age only)

[] 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:

[] Single
[] Married
[] Widowed
[] Divorced
[] Separated
[] Priesthood

Number of children ever born alive:

[Ask only women who have been married]

18. Total born alive ______

19. Still living ______

20. Occupation last week (25 March - 31 March 1970) ______

[Also record the main occupation for the person who has a full-time job but is currently ill or is on a temporary break. Record "not working" if the person does not work.]

21. Reason for not working, if record "not working" in 20:

[] Seeking employment
[] 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:

[] Employer
[] Self-employed
[] Government employee
[] Private employee
[] Unpaid household worker

Part 3

For temporary visitors (less than 3 months) with usual residence elsewhere

1. Name and surname ______

2. Sex ______

3. Age ______

Usual residence:

4. Province ______

5. District ______

6. Sub-district ______

7. Village/ Municipal Area ______

8. Who in the family are they visiting?

[] All of the family
[] Some persons

Part 4 Housing questions

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:

[] 1 Detached house
[] 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?

[] 1 Yes
[] 2 No

27. Type of construction materials:

[] 1 Cement or brick
[] 2 Wood, cement, brick (mixed)
[] 3 Wood
[] 4 Local materials
[] 5 Old used materials

28. Tenure of house (excluding land):

[] 1 Owner
[] 2 Buy on installment
[] 3 Rent

Live without paying rent because:
[] 4 Payment in kind for service
[] 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:

[] 1 Owner of land
[] 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?

[] 1 Government
[] 2 Government agency
[] 3 Private

32. Period of construction:

[] 0 Less than 1 year
[] 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:

Number of bedrooms _____
Other rooms used for sleeping _____

34. Toilet facilities

Flush toilet:
[] 1 Shared with other households
[] 2 Exclusive use
Molded bucket latrine:
[] 3 Shared with other households
[] 4 Exclusive use
[] 5 Pit
[] 6 Other or none

35. Fuel used for cooking:

[] 1 Charcoal
[] 2 Wood
[] 3 Gas
[] Other, specify ____

36. Type of lighting:

[] 1 Electricity
[] 2 Pressure lamp
[] 3 Other oil lamp
[] Other, specify ____

37. Water supply system:

[] 1 Piped water, inside
[] 2 Piped water, outside
[] 3 Public well
[] 4 Private well
[] 5 Rain water
[] 6 River, canal, etc.
[] Other, specify ____

38. Equipment:

Radio:
[] 1 Yes
[] 2 No

Bicycle:
[] 1 Yes
[] 2 No

Motorcycle:
[] 1 Yes
[] 2 No

Sewing machine:
[] 1 Yes
[] 2 No

Electric fan:
[] 1 Yes
[] 2 No

Television:
[] 1 Yes
[] 2 No

Motorcar:
[] 1 Yes
[] 2 No

Motorboat:
[] 1 Yes
[] 2 No

Refrigerator:
[] 1 Yes
[] 2 No

Pump for agricultural use:
[] 1 Yes
[] 2 No

Tractor:
[] 1 Yes
[] 2 No

39. Number of livestock:

Cows ______
Buffaloes ______
Pigs ______