Questionnaire Text

Questionnaire form view entire document:  text  image

17. During the last year (Jan. - Dec. 1991), did anyone who lived in this household die (including children and newborn infants)?
[Question 17 was asked of persons in occupied private dwellings, per Questions 1 and 2.]

[] 1 Yes
[] 2 No


17.1 How many were males and what was their age at death?

____ Number of males
_ _ Age or ages
_ _
_ _
_ _
Note: If the person deceased before reaching one year of age, write 00. If the person deceased at age 98 or older, write 98.

17.2 How many were female and what was their age at death?

____ Number of females
_ _ Age or ages
_ _
_ _
_ _
Note: If the person deceased before reaching one year of age, write 00. If the person deceased at age 98 or older, write 98.

Questionnaire instructions view entire document:  text  image

Question 17. Last year (January - December 1991), did anyone who was living in this household die, including children and newborns?

You should emphasize that only the passing of people, relatives or otherwise, who were usually living in the dwelling should be taken into account. The passing can have occurred in the home or outside of it, for example in a hospital or other assistance establishment, etc.

If they report No, continue on to question 18, without asking the next two questions.


17.2 How many were women and at what age did they pass away?

You should record the number of women in the household who died, recording their age upon passing away, clarifying that this concerns deaths that may have occurred from January to December of 1991.