Questionnaire Text

Questionnaire form view entire document:  text  image
Events occurred in the household in the last 12 months

Births: has there been any births in the household since ____ [date to fill out]

(Circle the applicable number)
[] 1 Yes
[] 2 No
If yes, how many? _ _
Questionnaire instructions view entire document:  text  image
Events that occurred in the household during the last 12 months

Births:
This applies to children born alive to women residing in the household.
The census agent shall ask the following question to the head of household: "Were there any births in the household since January 1st,1991?"
If the head of household's answer is No, the census agent shall report "0" (zero) in the grid situated above the table "Births" and shall then proceed to the section "Deaths."
If the answer is Yes, the census agent shall ask, "how many?" i.e. how many births has there been in the household during the last 12 months. He shall report the number in the corresponding grid and fill out the columns in the table of births.

Column (1): this is the column for the number of births in the household in the last 12 months.