Questionnaire Text

Questionnaire form view entire document:  text  image

How many more rooms are in the dwelling (don't count hallways or corridors)
Number ____

Questionnaire instructions view entire document:  text  image

Bathroom, Kitchen and other Rooms

[Depiction of enumeration form; section on bathroom, kitchen and other rooms.] In all cases, the three questions should be asked and the three answers written down. In the first two, mark the answer with an X. In the last question clearly write the number of other rooms that the dwelling has.

In the cases where there is a common bathroom for the occupants of various dwelling, the bathroom should not be written into any of the questionnaires.