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?

h. Household number ______

i. Type of household:

Part 2

For every person

1. Name and surname ______

2. Relationship to head of household:

3. Sex:

4. Month and year of birth______

5. Age (in full year) ______

6. Residence status:

7. Religion:

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:

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

15. School attendance and grade, as of January 1970

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:

Number of children ever born alive:

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

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

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:

Part 3

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

1. Name and surname ______

2. Sex ______

3. Age ______

Usual residence:

8. Who in the family are they visiting?

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:

If marked "5" or "Others," terminate the interview.

26. Is this house used for commercial purposes?

27. Type of construction materials:

28. Tenure of house (excluding land):

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:

31. If rent or rent-free in question 28, who is the owner of the house?

32. Period of construction:

33. Number of rooms used for sleeping:

34. Toilet facilities

35. Fuel used for cooking:

36. Type of lighting:

37. Water supply system:

38. Equipment:

39. Number of livestock: