Questionnaire Text

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Fertility
(Ask married, widowed, and divorced females age 12 or older)
[Questions 22-26 were asked of married, widowed, and divorced females age 12 or older]


Ask those who have responded "Yes" to question 24
[Questions 25-26 were asked of ever-married women age 12-50 who gave birth in the preceding two years, as per question 24.]


26. What is the full date of birth and sex of this child?

____/____/19__
1 [] Female
2 [] Male

Questionnaire instructions view entire document:  text  image

Section IV: Questions regarding individual characteristics (8-34)
This section includes questions (Questions 8-34) about the population's social and economic characteristics. In this section, only write the characteristics of those people present at the time and place where the census is being conducted. Whether the household head is at home or not, be absolutely sure to begin by first writing his/her name and surname on the first line of Section IV, together with all of his/her characteristics (from Question 8 to Question 34). Take care that the household head's name and surname entered in this section are identical to the ones written in the first line of Section III.
After writing down all of the characteristics of the household head, whether he/she is at home or not, (except for household members not at home) also write down all the characteristics of all the household members who are present at home, beginning from the oldest and proceeding in order of age, from oldest to youngest. After the household members, write using printed letters into the pertinent section and in order of their ages the names surnames and all the characteristics of those who, while being present at home, are not household members (guests). Answer questions with a box by placing an "X" into it.


[Questions 21-34 are for persons age 12 or older]


Fertility status (22-26)
(Married, widowed, or divorced women age 12 or older)


Question 26: In addition to the day, month and year of the date of this live birth, what is the child's gender?

In Question 25, write the day, month and year of this most recently born child's birth date into the appropriate section, whether this child is alive or dead. If the day of the birth date cannot be recalled, be sure to obtain the month and year. Furthermore, place an "X" into the 1 "Female" box if the child was a female and into the 2 "Male" box if a male.