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Questionnaire Text

Questionnaire form view entire document:  text  image
I. General Data of the Person Enumerated
[Questions 1-10.]


3. Date of birth

_____ Day
_____ Month
1 _ _ _ Year

Questionnaire instructions view entire document:  text  image
Filling in part "I. General data on the enumerated persons"

1. Family and last name

In case of married, widowed, and divorced women, the maiden name should be marked.

3. Date of birth
Provided the enumerated person was born in 1879 or earlier, a cross (X) should be put on the upper right part of the Dwelling questionnaire.