Questionnaire Text

Questionnaire form view entire document:  text  image
VII. A. All ages
[Questions 1-13 were asked of persons of all ages]


Q.7 Place of birth

Province ____
Regency/municipality ____

Questionnaire instructions view entire document:  text  image

X. Information on household members

A. Block VII: General information on household members
1. The objective of this block is to record information on items such as sex, age, schooling status, and activities conducted during the past week for every household member, starting with the member with serial number "01" and continuing to the last household member.

2. Method of filling out the form
Circle one of the codes corresponding to the respondent's answer, and then write the code in the box on the right.


B. Block VII. A: Persons of all ages


Question 7: Place of birth
Fill in the name of the province and regency/municipality of the respondent's place of birth. Province/regency/municipality of the place of birth is the province/regency/municipality of the mother's place of residence at the time the respondent was born. For example, a mother resides in Bandung (West Java); she gives birth to a child in Solo. If the mother and child return to Bandung (West Java) in fewer than 6 months, then the child's place of birth should be recorded as Bandung (West Java). However, if the child remains in Solo for 6 months or more, then the child's place of birth should be recorded as Solo (Central Java).

If there has been a change in the name of the province/regency/municipality, then the recorded place of birth should be the name of the area at the time of the enumeration. For example, A was born in Cakung sub-district, Bekasi regency, province of West Java. Because of the expansion of DKI Jakarta [DKI Jakarta is the special capital region Jakarta and is a city/province], at the time of the enumeration, Cakung sub-district is included as part of DKI Jakarta. Thus, the place of birth of A is the province DKI Jakarta, not West Java.

[pg. 53]

Fill in the code of the province as shown in the table that appears below block IV on the questionnaire. Leave boxes 30 and 31 blank.