1 - ESDS

-.
Qumstaonnalre Raf
Qumstmn No
PERSON
IDENTIFICATION
Q1
Q2
FANILY INTOSNA’2!ION - SELF CO~LETI02i
MSN
Codang Shaat
Raf ●rmnco
IDNO
H/5i NO
PER
b-u
Q1
92
NO of
B0x9s/
Cimractmrs
5
2
2
2
2
2
Codang Instructions/Ramarks
Values 00001-49999
5 d~glts - remember
leading zeros. [Check that
th* number is tha same as
that on the front page of
the household echedule. ]
values 1-5
Enter household number.
Valuee 1-21
Chack that tha intorvaowar
haa recordmd the correct
parson number bmfore
●ntering.
~11 1-7
Entar numbar of famdy unit.
Valuas -3-03
Mar>tal status7
Xarr~ed or living wLth
someona ae a coupla. ... ...01
Single ....................02
Widowed, dLvorced,
saparatad ....... .........03
~ume
--
Placa of msrriage?
4
In Church .................O1-
At a RmgLstry Office. .....02
Both Church and Raglstry
of fLca ............... ....o3
Living togather am a
couple ...................04
176
I
‘,