Questionnaire Text

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A. Identification

1. Department ____ _ _

2. Location or locality
Name ____ _ _ _
Category (indicate if it is a city, villa, village, town, etc.) ____ _ _ _


3. Census section ____ _ _

4. Segment ____ _ _

5. Area
[] 1 Urban
[] 2 Rural

6. Zone ____ _ _ _ _ _

7. Order number of the enumerator within the zone _ _

8. Address
____ Street or road
____ No.
____ Floor
____ Apt


9. Order number of the dwelling
_ _