Thirty four questions will be asked of the leader of the family.

There are two forms.

Form A is the house list that gives the following general information:

What is the predominant structure of the building? What is the name of the head of

the family and how many people are usually living in the house?

Form B is the household questionnaire that will identify the population in

the house:

Usual members present on survey night: with their name, relationship to head of household,

and sex.

Visitors present on survey night: with their names, relationship to the family head,

sex and usual residence.

Usual members absent on survey night: with their name, relationship to head of

household, sex, age, address on survey night, and how long did he or she stay absent.

For each individual: full name, relationship to the head of the household, sex,

age, date of birth for children below 10, marital status, mother tongue, religion,

birth place, previous residence, duration of stay, reason for migration, literacy,

full time education, main employment activity, employement period, occupation, employment

status in their job, industry trade or service, sector of employment (private or

public).

For females aged 15 and over: Number of children born, particulars of birth in

the last 12 months.

On the housing conditions and facilities: On what basis do you occupy this dwelling?

What is the main source of light? What is the main cooking fuel?

Do you have a toilet facility on the premises? What is the main source of drinking

water supply?

How many rooms are occupied in the household?

On deaths in household in the last one year: Number, name of the deceased, sex,

relationship to head of household, age of death.

Deaths in household of females aged 15 and over during March 1,1993 to February

28, 1995:

Numbers of deaths, year of death, name of deceased, relationship to head of household

age of death.