Questionnaire Text

Questionnaire form view entire document: text image

Note: Remember to record these totals, transferring the results from form C2:

_ _ _ Total population
_ _ _ Total number of men
_ _ _ Total number of women

1. What are the names of the people of this dwelling who spent the night here from Friday to Saturday?

Write down the names and the relationship to the head of household in the following manner: Head, spouse, child, stepchild, daughter/son-in-law, grandchild, parent, mother/father-in-law, other non-relatives, domestic servants, and their families.

If there are more than 7 people: (1) Continue in another document. (2) Fill in the block "Geographic Location" with the information from this document and continue with question 1, writing down the people to be listed, starting with the second line.

Person No. _ _
Name ____
Relationship to the head ____