1. Province or préfecture
2. Cercle
3. Municipality or centre autonome or commune rurale 3. Centre
4. Fraction
5. Douar
6. Census track [district de recensement]
7. Dwelling unit number [numéro du logement]
8. Number of households in the dwelling unit
9. Household number [numéro du ménage]
10. Number of questionnaires filled for this household
11. Does the household head have a vital registration booklet?
12. If yes, year of issue of this booklet
13. Number of resident household members (not counting the visitors)
Moroccan __
Foreigner __
Total __
14. Precise address of the dwelling unit
15. Name of the census enumerator
16. Name of the respondent
17. Date of interview
18. Name of the supervisor
19. Date of the supervision
in the office _____
in the field _____
20. Signature of the supervisor
21. Observations