Questionnaire Text

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


Q.10 Previous residence

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 10: Previous residence
Fill in the name of the province and regency/municipality of residence prior to the respondent's current residence.

Example: A has lived in Pekalongan regency for 2 years. Before that, he lived in Sleman regency (special province of Yogyakarta) for 1 year, and before living in Sleman, he lived in East Java for 3 years. The answer for Q.10 is Sleman regency (special province of Yogyakarta) and the answer for Q.9 is 2 years.