Questionnaire Text

Questionnaire form view entire document: text image

I. Location of the Dwelling

1. Province or Region ____
2. District ____
3. Judicial Precinct ____
4. Segment ____
5. Block number ____
6. Locality ____
7. Neighborhood or Vicinity ____
8. Street or Avenue ____
9. Building or House ____
10. Room or Apartment number ____

Questionnaire instructions view entire document: text image

Province or Region, District and Judicial Precinct
Carefully write in the corresponding spaces, the number of the province or region, district and administrative unit where the enumerated dwelling is located.