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I
CONFIDENTIAL
EASTEHN
C A R I B B E A N RI
SECTION I
PUPULATXQN 6:
County/Parish/Quarter
(One Schedule to be completed For
............................................................
Wa rd (i f app Z i cab Z e) ...........................................................
FOR 01
Enumeration District Number .............................................
Type of Area ..............................................................................
ho. o f Families or Domestic L’nits .....
Schedule PJumber ........................................................................
WQ.
k.
of Persons per
Room ....................
o f Rooms .... ........................................................................
1
y p of Household.. ......................
Address of Houxehold/Bui lding ..................................................................................
...............................................................................
Torm/Dis trie t /Loc d i t y
SECTION II
-
Coder ............................
--
I
TYPE
Bik th- E x n i c
Origin
CARD
yrs.
and
months
as
Surname and main
Reiations hip
Christian Name
I
fractions of
o
Coder
Birthplace
day
1
-
Race
Last
Age
OF
SECTION I
-_____
year
for
c hfldren
under 3
years of
Age
N
W
I
CH
M
P
A
If in this town/locaiitg
writ e ‘here
’
f4 tn this town/LJcefitty
write ‘here’
1 local
at sch
Religion
If elFeWher- in t h i s
territory g i v e town BI
locality End name of
neme at town.
enter a s stated by
respondents
C
in
nearest town.
s. c
re s c 11 t
resi-
N.E.
U.1
u.7
If abroad, g i v e n a m e
of country o d y .
INDIVIDU A L
live in this Tenitory.
1
: I
i
i
I
l
I
i l
O3
-&- ! J I
i
_
I
-
IND IVID U A L
NO.
I
R
E
M
A
R
K
s
3 for each hdusehold, 3 n e line for each individuai)
Ikte of Preliminary Enumeration .............................................
I R OFFICE USE O N L Y
Enwne r a to r .......................................................................................
Checked by Supervi so r ..................................................................
i t s ...........................................
Checked in O f f i c e ........................................................................
FOR OFFICE USE ONLY
,
............................................
T o t a l Number of persons
Total Number o f families
SECTIQX IV
i
Coder .. ......................
.
.
I
_
_
_
I
I
ighcst Level
Education
At t a ined
jf
cl. children ~ i l l l
at school
I
1
I
,,'-
,
SECTION V--
If a:tending school, g i v e
I
(a)
schml
7
,
,
'
Narce of person of f
h
tionhave
al
a job
,tatue durduring
the
by whom
employed for moat of the pest 12 mths.
engaged
paat 12 rnontha.
U.D.
I
-
for MoSt of the Time durhg the
in which e m l i e
N.S.C.
U.N.
E.F.C.
.........................
YOU
Type of Job i n w N c h
s. c .
Coder.
--
I
w:;o\ horn
(b)
Type of b u s i n e s s
Oh
c d e d o n by
employer
UA
Rocard i n detaif
i'/ì
FW
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