3-Sex

&-)(onth and year of birth

5-Ethnic group

nate . . . . . . ' F C M l C

b . . . . . . 1.- - - I

I

h t h . Year

11 Kinh - Other than Kinh . . . . . . . . . . . . . . . specify --

89.

Abroad' - 4 .

7-Literacy

B-a/SchooL attendance or equivalent

I bhigliest grade completed I

. . . . . . . . I Yes No : .- Attending nou *

Attended in the past . . . . . . Never attended *

Grade . . . . . . . . - - . . . . . . I

I

trade

b/ Field of study

2

4 . . . . . . .

I - 3I

- 51

Technical worker vith certificate

Hiddle vocational education Technical worker no certificate - College / university degree - Post-graduate - 6

. . . . . . . . . . . . . . . . - - -.

5

1 11-Usual activity i n Last . Uorked 6 months and over * - 12 mths Vorked permanently less then 6 lnpnths - 2

Uorked temporarily less than 6 months - 3 4 Unemp toyed - 5 Student - 6 Household duties -

. ? Inva 1 id, - 8 Other , -

12-win occupation ---

- -. c

Separated . 1 '

. . . . . . . . . . . . . . . . . . . . 13- a/ N a m e of establishment a/

' I I I

. . . . . . .

. . . . . . ,7

I

. uharc perron works b/ Function,product of

c/.secior of industry . . ertablishment I s t

o b / . . . . . . . . . . . . . . . . . . c/ . . . . . . . . . . . .

* ,

I . . . . . . . ß-Hou meny of your children Live a- I .

with you . . . . . . . . . . . b - h ?ny of your .children l i v e b- s . , . * clreuhere

d-Total r W a r of children ever

. . . . . . . . c-& many of your children not c- --

. . . . . . . . . d- -- ' I living

I ' born ,alive4 ' * .

e-?, mnth i'nd yerr -dM ywr e- M t h ' -- iT~ar,.i$i &,or a girl 1: BOY - g-ï, thaj chil,! ti(ii9rw I g- yes,stilt living -

"last birth occur Year 19 - 1 2

I . 1 . Girl - 3 4

* . - Mo, did , r . * I

I I I

I I I

'. I 'I

. .

t

. . . . . . I I

. . . . . . .

1-full luw of each usual

2-Relationship to the hed

residant In thi8 h?us.hold

of houschold Child . - Father I Rother - 4 Grand child - 5 Other tniiy'relmtlve * . -'6 Mon fuily relation - 7

3-sex

I . . . . . .

L

4-Nonth and year of birth -- llonth Yrar I - . - -

- 1 . - 2

Ki& Other'than Uinti . . . . . . . . specify --

I

5-Ethic group

. ', - . . . . . . .

. . . . . .

, . CDR PERSOWS BORN ON

, 1 . 1-4-1984 (!?e Siyrars agn) Another district of the same province - 2 6-Place uhem usually lived on The s u e district -

Nut of the district . . . . . . . . . . . - - . - 3 Another province

NOW of t h province . . . . . - - . . Abyd 1 . -

741 teracy I J

Yes . . . . . . . Ho

Attended in the pr s t - 2 . . : . . . b/Highrst grde coaplete?,

-Never attended - 3

G r a d e . . . . . . . . - - . FOR PERSONS BORN ON

- I .

. . . . . . .

9- al Highest qualification or t rute

Technical wrkrr no c e f t i f w t e - 3 . nlddle 'vochtionel education ' - 4 College I wliversity-degree . - 5 Post-gradqatc - 6

Single . - - 1 - 2

* - 3 Ikrrird

' ' 4 Uldovtd' ' Divorced Stprated

Uorked 6 .ontht and over ' Uorked permanently less than 6 kths ,_ 2 Uorked temporarily lesa Jhan 6 rronthr - 3

. . . . . . . . . . ---

- - - 1 '

b/ field of study

10-hrttaL statw

. . . . . .

. . . . . . . '

. . . . . . 5 .

. . . . . . l l - U y l activity in last

12 D0ntll.s

- 6 7

Household dut ies * - Other - 8. hvalid , - . . . . . . . . . --- - .

. . . . . . . . - . a/.

bl . . . . . . . . ---- c/ . . . . . . . . . -

12-Min occupation-

I . . . . . . I . . . . . I

13- a / Haw of establishaent ... . where person works . bl Function,prpJuct of

CI Sector of industry . establishaent

0-16 thst child living now '

~~ ~

14-ALL WEN .BORN FR

a - w uny of your children Liva

b-Hov bany of ydr children live with you

* elsewhere

Girl g-'Yes,still living

4 No, died - .

C

70

HOUSING CENSUS FORM

m1 2. Living areas (Spm)

U D *u

Prwince * .......*......................... r] . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . m Dism.ct

Caninraie . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ED iriunbcfi . . . . . . . . . . . . . . . . . . . . . H a ~ k l i d d i,ru,;ber . . . . . . . .* . . . . . . Taalpcrsats iii harseltdd . . . . . . . . .

Naim of head’s liarselidd . . . . . , . . :. . . . . . . . . . . . . . . Tad feiriales iii liarselidd . . . . . . . . . n 1. Type of housing

a- Pet@&- (villa, many-storied house, plan roo0 b- Semi pexmanent (a brick house, a house roofed with tiles)

c- a h e r (thatch house including other types)

(Bed room, diner rodm, waiting m m ete) .

3. Housing conveniences : a H%er si yply :

- Piped inside of house - Piped outside of house - Well - Other

b. Electric fcx liglitbig

c- Tci!et facilities :

- Yes - NO

- Yes - NO

* Toilet with flushing facilities * Double tank * Other

- _ .-_-

U

U

CI U

1 2 :3

4

1 2

1 2 3 4 5

4; Type of ownership - State sector - Private sestor - Collective and Religion sector - Others

u3 04

6. Year and period of construction : 5 Before 1954 01

- From 1954-1960 o ‘2 1961-1975 c13 1976-1980 u 4 198 1- 1985 0 5 1986 DG 1987 0 7

1988 08 1989 *o 9

Sign of Enumerator

76

Date Month Year 1989 Sign of head’s household

l h l k . . . . .m 5 . dn& ngok O . .

I . . . . .

Id Lbl CAC CAU tídl SAU.

a/ . . . . . . . . . . . . . . . . . . w. . . . . . . . .

ddnvl- * . . . . . . . . . . . . . . . . . . . . . . . d Tliiri!ipl?An klrili IÖ c r . . : : . . . u CØ . . ...a G l . : . . . *o

14. TAT CÀ NHGNC PHU NÜ SiNH lÙ 1 - 4.1339 Dgt4'3t -3 - 1974 (TÙ 6 D f N 49 Tubl) TR'A LÕ1 C

LQ.. . . . . DI

bl CÁC CAU 1161 SAU- * ,

J I . . . . . . . b l . . . . . . *d...-. . . . I I '

dl.. *E3 etrnhlnO a

N l m 19 O I/ Ttd Ul

o II U 2 g r a n rdno o 3

o1 dlk u 4

tiEU Cd GHI MUC 15

. . . .

J

r I I 1 1

PHIEU DÃNG ~ NHÀ 6

2. Di+ tích ¿3 (mét vutmg) (bao &m dien tích dùng d6 an, ng& tigp khách v.v) m

Tinli, tlidtih plid:

Higcti, qiigti, tlii.uri : .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [I]

1 7 1 @a bdn sb:

HOsb: ......................... . . . . . . . . . . . . . . . . . . . . . O'

D

- NU'& máy VAO nh8 - NU& d y ci3ng @ng - NU& g ihg xay - Các l+i khác

b) Ndtig l i p i g tlidp shtig : - Có dien - m a n g cíj dien

c) Cd d i d t*ê sidi ribig kli alg ?

- có - m a n g + Nhà xí t$ h+i và bán t$ hoai + Nhà xí hai n@n + Cácloai khác .

,

1

xã, phrr&tg : .. I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Hovdtêt tc l tr i l iô: ....... .......... .. ............. Dia chi ciìa ha :

= T&gabl*~r¿ifruisr*~:. . . . . . . .-. . . . ' 0- . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . T&g sbt i 3 trw ig Ii (3 : . . . . , . . . . . . . . . 0

1. Lu$ nhà dang a a) Nhà kien ca' (bi$t thv, nhh cao hng, nhh mái bhng)

b). Nhh bán ki8n ca' (nhà t&ng xay, &, d i ngói, mái tan)

c) CQc l+i nhà khác (am nhà g6, tre, feu, lán t q i ...)

ci1 u 2 u3

i . Tien nghi nhà a a) Ngribt ,ivdc

ci1 u 2 133 u 4

01 02

a 2 u 3

4. Quien d hiíb nhà ¿3 : - Nhà clia Nhà nUdc - Nhà cüa ttl n h h - Nhà cua khu v$c @p th6 Mn gino - Nhà chtb x-6 ng&n sÛ hini

U ' c12 1 1 3 e14

5. N(lun x%y d e g nhà : ' - Tx~fdc nilm 1954 - Tii r@m 1954 dgn M m 1960 - Ta m m 1961 d6n M m 1975 - Tii M m 1976 Ugn n8m 1980 - Tanilm 1981 &'n 1985 - Nam 1986 - Nam 1987 -Nam 1988 - Nam 1989

, Dku tra vibri (ky, ghi ró ho t2n)

Ngày tháng 4 n3m 1989 ChÛ ho (e, ghi ró hr, t&n)