Questionnaire Text

Questionnaire form view entire document:  text  image

1. Province ____
2. Regency/municipality ____
3. District ____
4. Village/Kelurahan ____
5. Area
[] 1 Urban
[] 2 Rural
Questionnaire instructions view entire document:  text  image

Question 1 through Question 7
Copy the name of province, regency/municipality, district, village, urban/rural area, enumeration area number, and sample code from the sample list SP90. Code of province, regency/municipality, district, village, urban/rural area, enumeration area number, and sample code [must be] in accordance with the filling of space of Block I, Questions 1 to 7, SP90-DSRTs (Sample list, Enclosure 1). Sample list SP90-S can be seen in Appendix 2.

Question 8: Serial number sample (NUS)
Write down NUS in the available place and move to the box on the right. NUSs are copied from the SP90-sample list Block III column (1).

Question 9: Physical building number (NBF)
Write down the NBF in accordance with the SP90-sample list Block III column (2).

Question 10: Census building number (NBS)
Write down the NBS in accordance with the census building number in the SP90-sample list Block III column (3).

Question 11: Selected household number
Write down the selected household number in accordance with the household serial number in SP90-sample list Block III column (4).