Questionnaire Text

Questionnaire form view entire document:  text  image
Phase II

[] K Urban
[] P Rural

I. Information on location

1. Province ____
2. District ____

Domain _ _ _

3. Sub-district ____ _
4. Village ____ _
5. Cluster no. ____
6. Census block no. ____
7. Building no. ____
8. Household no. ____ _ _ _
9. Address or location ____
10. Total no. of household members _ _

Questionnaire instructions view entire document:  text  image

1. Urban/rural areas.
1.1. Concept and definition
Villages that are classified as URBAN or villages that are classified as RURAL are detailed in the sample list provided by the Central Bureau of Statistics. Every enumerator, supervisor, CBS regional offices level II and I will receive a copy of the sample list indicating whether the area assigned to the enumerator is urban or rural, the names of the villages and the number of the cluster.
[An example of the sample list and method for completing the form on the original document are not presented here.]

Location identification.
This location identification section should be filled in before conducting the interview, that is, by copying from the sample list, except for items 7 - 10, which can be filled in when conducting the interview.