Questionnaire Text

Questionnaire form view entire document:  text  image
1. The data of the persons living in the dwelling

[The form provides a table with space for each person living in the dwelling.
Instructions for this set of questions are given below.]

Serial number of the household: ____

The person's serial number [pre-filled, number 1-8].

The person's surname and name: ____
Maiden name, for those not bearing the name of their husband, also the name of the husband, in case of a partner-in-life relation, also the name of the partner-in-life.