Questionnaire Text

Questionnaire form view entire document:  text  image

IV. Mortality and migration
[Section IV was asked of occupied private households, per question 3 and Section 1.]


1. Mortality
1. Did any member of this household die during the last year or this year?
(Do not forget to ask about children and elderly persons)

[] 1 Yes - give details in table below
[] 2 No - skip to migration
[] 3 Unknown - skip to migration

Person number ____
Name and surnames ____
Date of death:
Day ____
Month____
Year ____

Sex
[] 1 Male
[] 2 Female

____ Age at death (put "00" for those younger than 1 and "98" for those 98 or older)

Questionnaire instructions view entire document:  text  image

4.4.1 Mortality
Have any of the members of this household died last year or in the present year?
People who died in the period between January 1st of the last year and just before the date of the census, including children and elderly people, will be registered.