| Household Members | Family relations | Marital status: 1.single 2.married 3.widowed 4.divorced |
Gender: 1.male 2.female |
Birth (MMYY) |
Age (write 97 if age >= 97) |
If 404=2, does the spouse live in this household?: 1.yes 5.no |
If 404= 2,3,4, age at first married? |
For person age 0 - 17 yo | For person age 0 - 10 yo | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Have a birth certificate? |
If 410=5, why? |
Ever attended pre-school? |
if 412=1,2,3, what type of pre-school | |||||||||
| 401 | 402 | 403 | 404 | 405 | 406 | 407 | 408 | 409 | 410 | 411 | 412 | 413 |
| Copy the answers from Block IV | Only if age >= 5 yo | Only if age 5-24 yo | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No | Household Members | Age | Literacy | Attend any education? | Highest level of education attended? | Highest grade attended? | Highest school certificate? | The school location? (PPRRSSS) P=Province R=Regency S=Sub-district |
If currently not in school (507=3), the year you quit the school? | If ever attended a school (507=2 or 3) | ||||
| Latin Letters? 1. Yes 5. No |
Arabic Letters? 1. Yes 5. No |
Other Letters? 1. Yes 5. No |
Active student in the previous school year? | If 513=2, what level of education did you attend? | what grade were you in the previous school year? | |||||||||
| 501 | 502 | 503 | 504 | 505 | 506 | 507 | 508 | 509 | 510 | 511 | 512 | 513 | 514 | 515 |
| Copy the answers from Block IV | Ever did a commercial tourism/travelling in the past 6 months? 1.yes 5.no --> 608 |
Number of vacations taken |
About the last trip | Between March '15- Feb '16: ever be a victim of crime? 1.yes 5.no |
If 608=1 | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| How many times and where did it happen? | Number of crimes reported to the police | If 619>0, Number of reported crimes investigated by the police? | |||||||||||||||||
| Theft | Persecution/Violance | Robbery | Sexual Assault | Others | |||||||||||||||
| No. | Household Members | Sept- Nov '15 |
Des '15- Feb '16 |
Purpose | Destination Province |
Number | Location | Number | Location | Number | Location | Number | Location | Number | Location | ||||
| 601 | 602 | 603 | 604 | 605 | 606 | 607 | 608 | 609 | 610 | 611 | 612 | 613 | 614 | 615 | 616 | 617 | 618 | 619 | 620 |
| 1. head of household | 6. grandchild |
| 2. spouse | 7. parent/ in law |
| 3. biological/ step child | 8. servant/ driver |
| 4. adopted child | 9. others |
| 5. son/daughter in law |
| 1. yes, can be shown |
| 2. yes, cannot be shown |
| 5. no |
| 8. do not know |
| 1. has not been issued |
| 2. has no money for the registration fee |
| 3. the office is far away |
| 4. do not know that birth must be registered |
| 5. do not know how to register |
| 6. not necessary |
| 7. do not care |
| 8. others |
| 1. Attending in this school year |
| 2. Attended in last school year |
| 3. Attended before last school year |
| 4. do not or never attended |
| 1. kindergarten |
| 2. bustanul athfal, raudhatul athfal |
| 3. early childhood education (PAUD) |
| 4. play group |
| 5. day care |
| 0. None |
| 1. inside the house |
| 2. outside the house |
| 3. inside and outside the house |
| 8. don't know |