Questionnaire Text

Questionnaire form view entire document:  text  image

21. Between May 15, 1999 and today, has any member of this household died?
[] 1 Yes

[Under "yes" an arrow points to a table with spaces to fill in the following information for up to four individuals]
____ 1. Name of the person
_ _ 2. Age at death
3. Sex (male or female)
[] 1 Male
[] 2 Female

[] 2 No (Go on to the List of Occupants, Section IV)
Questionnaire instructions view entire document:  text  image

Question No. 21: Between May 15, 1999 and today, has any member of this household died?

This question has the purpose of knowing the general current mortality of the whole population, from the period of May 15, 1999 to the census date, that is to say, the mortality in the last twelve months.

[To the right of the text is a picture of three crosses.]

If the marked response is yes, write down the name, age and sex of the deceased person. Write down the age in completed years of the person on the last birthday.
Remember that this question is concerning the members of this home and not of the family.
If a person declares that the deceased person was 98 or older write down 98. Only completed years are considered; the minors of one year are registered as 00 years.
If the answer is " no" continue to Section IV. List of Occupants.