Questionnaire Text

Questionnaire form view entire document:  text  image
[The rural and urban census forms are identical for questions 1-17. Questions 1-17 are provided here in detail under the rural census form, and omitted in the urban census form.]

For all persons
[Questions 12-15 were asked of all persons.]

15. Belong to a church

Circle one code only

[] 1 Yes
[] 2 No

If "yes", give name of church (religion).
Religion _ _