Questionnaire Text
Questionnaire form
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___ No. of census division
___ No. of instructor district
___ No. of enumeration district
___ List No.
___ Form No. within portfolio
___ Region
___ Avenue, street, by-street
___ District
___ House No. or name of house owner
___ Apt. No.
___ Rural Council
___ Settlement
___ Institution