Questionnaire Text

Questionnaire form view entire document:  text  image

VI-A: All ages
[Questions 1-13.]


VI-B. Persons age 5 or older
[Questions 14-23.]


14. Dwelling of [respondent] five years ago

Province: ____

Questionnaire instructions view entire document:  text  image

B. Sub Block VIb. For respondents age 5 or older


Question 14: Place of residence five years ago
Ask the respondent in which province he/she lived five years ago.
Example Question 8-11, Bakri worked for for years in Kabupaten Situbondo; then the answer to Block VIb question 14 is East Java province.