Questionnaire Text

Questionnaire form view entire document: text image

A. Questions to all persons

2. Date of birth

Day____
Month____
Year____

Century/Decade
[] 187
[] 188
[] 189
[] 190
[] 191
[] 192
[] 193
[] 194
[] 195
[] 196
[] 197
[] 198

Single year
[] 0
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8
[]9

Questionnaire instructions view entire document: text image

Question 2: Date of birth

Marking the year of birth saves costs for the government and allows early release of the main results from the census.