‫‪The Hashemite Kindom of Jordan‬‬
‫داﺋﺮة اﻹﺣﺼﺎءات اﻟﻌﺎﻣﺔ‬
‫‪Department of Statistics‬‬
‫‪Census is an insight of the present & the future‬‬
‫اﻟﺘﻌﺪاد ﺻﻮرة ﻟﻠﺤﺎﺿﺮ واﻟﻤﺴﺘﻘﺒﻞ‬
‫‪POPULATION & HOUSING CENSUS‬‬
‫‪2004‬‬
‫ﺴﺠل ﺍﻟﻤﺒﺎﻨﻲ ﻭﺍﻟﻤﺴﺎﻜﻥ‬
‫ﺍﺴﻡ ﺍﻟﺒﺎﺤﺙ ‪:‬‬
‫ﺍﺴﻡ ﺍﻟﻤﺭﺍﻗﺏ‪:‬‬
‫ﺍﺴﻡ ﺍﻟﻤﻔﺘﺵ ‪:‬‬
‫ﺍﺴﻡ ﺍﻟﻤﺸﺭﻑ ‪:‬‬
‫‪Building & Housing Register‬‬
‫ﻤـﺭﺤﻠـﺔ ﺍﻟﻌـــــــــــــﺩ ‪Enumeration Stage‬‬
‫ﺍﻟﺘﺎﺭﻴﺦ‬
‫‪Interviewer‬‬
‫ﺍﻟﺘﺎﺭﻴﺦ‬
‫‪Supervisor‬‬
‫ﺍﻟﺘﺎﺭﻴﺦ‬
‫‪Inspector‬‬
‫ﺍﻟﺘﺎﺭﻴﺦ‬
‫‪Supervisor‬‬
‫‪/‬‬
‫‪/‬‬
‫‪/‬‬
‫‪/‬‬
‫ﺍﻟﻌﻨﻭﺍﻥ ‪:‬‬
‫‪2004 /‬‬
‫ﺍﻟﻌﻨﻭﺍﻥ ‪:‬‬
‫‪2004 /‬‬
‫ﺍﻟﻌﻨﻭﺍﻥ ‪:‬‬
‫‪2004 /‬‬
‫ﺍﻟﻌﻨﻭﺍﻥ ‪:‬‬
‫‪2004 /‬‬
‫ﻫﺎﺘﻑ‪Telephone :‬‬
‫‪Address‬‬
‫ﻫﺎﺘﻑ‪Telephone :‬‬
‫‪Address‬‬
‫ﻫﺎﺘﻑ‪Telephone :‬‬
‫‪Address‬‬
‫ﻫﺎﺘﻑ‪Telephone :‬‬
‫‪Address‬‬
‫‪ .5‬اﺟﻤـﺎﻟــﻲ ﺑﻴﺎﻧـــﺎت اﻟﺴﺠﻞ‬
‫‪155‬‬
‫ﻋﺪد‬
‫اﻟﻤﺒﺎﻧﻲ‬
‫×××‬
‫‪156‬‬
‫ﻏﻴﺮ‬
‫اﻟﻤﺄهﻮﻟﺔ‬
‫×××‬
‫‪157‬‬
‫‪158‬‬
‫ﻋﺪد اﻟﻤﺴﺎآﻦ‬
‫ﻣﺄهﻮل‬
‫ﻣﺄهﻮل‬
‫ﺑﺄﺳﺮة‬
‫ﺑﺄﺳﺮة‬
‫ﺟﻤﺎﻋﻴﺔ‬
‫ﺧﺎﺻﺔ‬
‫×××‬
‫×××‬
‫‪159‬‬
‫‪160‬‬
‫‪161‬‬
‫‪162‬‬
‫‪163‬‬
‫‪164‬‬
‫ﻋﺪد اﻷﺳﺮ‬
‫ﻣﺠﻤﻮع‬
‫اﻟﺨﺎﺻﺔ اﻟﺠﻤﺎﻋﻴﺔ‬
‫اﻟﻤﺴﺎآﻦ‬
‫×××‬
‫×××‬
‫×××‬
‫اﻟﻔﻨﺎدق‬
‫×××‬
‫‪165‬‬
‫‪166‬‬
‫‪167‬‬
‫ﻋﺪد اﻻﻓﺮاد‬
‫اﻷﺳﺮ‬
‫ﻣﺠﻤﻮع اﻷﺳﺮ‬
‫اﻟﻔﻨﺎدق ﻣﺠﻤﻮع‬
‫اﻻﺳﺮ اﻟﺨﺎﺻﺔ اﻟﺠﻤﺎﻋﻴﺔ‬
‫×××‬
‫××××‬
‫××××‬
‫××××‬
‫××××‬
‫ﺍﻟﺒﻴﺎﻨﺎﺕ ﺴﺭﻴﺔ ﺒﻤﻭﺠﺏ ﻗﺎﻨﻭﻥ ﺍﻹﺤﺼﺎﺀﺍﺕ‬
‫‪Data is confidential by virtue of the Statistical law‬‬
‫‪ .1‬ﺍﻟﺒﻴـﺎﻨــﺎﺕ ﺍﻟﺘﻌﺭﻴﻔﻴﺔ‬
‫‪101‬‬
‫ﺍﻟﻤﺤﺎﻓﻅــﺔ‪:‬‬
‫‪102‬‬
‫ﺍﻟﻠـــﻭﺍﺀ ‪:‬‬
‫‪103‬‬
‫ﺍﻟﻘﻀـــﺎﺀ‪:‬‬
‫‪104‬‬
‫ﺍﻟﺘﺠﻤﻊ ﺍﻟﺴﻜﺎﻨﻲ‪:‬‬
‫‪105‬‬
‫ﺍﻟﻤﻨﻁﻘﺔ ‪:‬‬
‫‪106‬‬
‫ﺍﻟﺤﻲ ‪:‬‬
‫‪Identification Information‬‬
‫‪Governorate‬‬
‫‪District‬‬
‫‪Sub-District‬‬
‫|__|__|‬
‫|__|__|‬
‫|__|‬
‫‪Locality‬‬
‫|__|__|__|‬
‫‪Area‬‬
‫|__|__|‬
‫‪Neighborhood‬‬
‫|__|__|‬
‫‪107‬‬
‫ﺭﻗﻡ ﺍﻟﺒﻠﻭﻙ‪:‬‬
‫‪Block No.‬‬
‫|__|__|__|‬
‫‪108‬‬
‫ﺭﻗﻡ ﺍﻟﺴﺠل‪:‬‬
‫‪Register No.‬‬
‫|__|‪|__|/‬‬
‫‪109‬‬
‫ﺭﻗﻡ ﺍﻟﺤﻔﻅ‪:‬‬
‫‪Archive No.‬‬
‫|__|‪|__|/‬‬
‫إﻟﻰ ‪2004/ /‬‬
‫ﺗﺎرﻳﺦ اﺳﺘﻴﻔﺎء ﺑﻴﺎﻧﺎت اﻟﺒﻠﻮك ﻣﻦ ‪2004 / /‬‬
‫‪Date of block data collection from‬‬
‫ ‪/ /2004‬‬‫‪/ /2004‬‬
Area
Neighborhood : ‫ﺍﻟﺤﻲ‬
Housing Unit Area ( in Sqm )
×××
‫ اﻟﺸﺒﻜﺔ اﻟﻌﺎﻣﺔ‬.1
‫ ﻣﻮﻟﺪ ﺧﺎص‬.2
‫ ﻏﺎز‬.3
‫ آﺎز‬.4
(‫ أﺧﺮى )ﺣﺪد‬.5
‫ اﻟﺸﺒﻜﺔ اﻟﻌﺎﻣﺔ‬.1
‫ ﻣﺮآﺰﻳﺔ‬.1
‫ ﺣﻨﻔﻴﺔ ﻋﺎﻣﺔ‬.2 ‫ ﺳﻮﻻر‬/‫ ﻣﺪﻓﺄة آﺎز‬.2
‫ ﺻﻬﺮﻳﺞ‬.3
‫ آﻬﺮﺑﺎﺋﻴﺔ‬.3
‫ ﻣﻴﺎﻩ أﻣﻄﺎر‬/‫ ﺑﺌﺮ ﺟﻤﻊ‬.4
‫ ﻣﺪﻓﺄة ﻏﺎز‬.4
‫ ﻣﻨﻘﺎة‬/‫ ﻣﻴﺎﻩ ﻣﻌﺪﻧﻴﺔ‬.5
‫ ﻓﺤﻢ‬/‫ ﺣﻄﺐ‬.5
‫ ﺑﺌﺮ ارﺗﻮازي‬.6
(‫ أﺧﺮى )ﺣﺪد‬.6
‫ ﻧﺒﻊ‬.7
‫ ﻻ ﻳﻮﺟﺪ‬.7
(‫ أﺧﺮى )ﺣﺪد‬.8
×
Source of
Lighting
1.Public
Network
2.Private
Generator
3.Gas
4.Kerosene
5.Other
(Specify)
×
Main Source of
Drinking water
1.Public
Network
2.Public Tap
3.Tanker
4.Well/Rain
water
5.Bottled water
6.Artesian well
7.Spring
8.Other
( Specify )
120
‫ﻧﻮع اﻟﺘﺪﻓﺌﺔ‬
×
Type of
Heating
1.Central
heating
2.kerosene/
diesel heater
3.Electricity
4.Gas heater
5.Coal /wood
6.Other
(Specify)
7.None
119
‫ﻣﺪة اﺷﻐﺎل‬
‫اﻟﻤﺴﻜﻦ‬
‫اﻟﻤﺄهﻮل‬
‫ﺑﺎﻟﺴﻨﻮات‬
118
‫اﻹﻳﺠﺎر‬
‫اﻟﺸﻬﺮي‬
‫ﻟﻠﻤﺴﻜﻦ‬
‫اﻟﻤﺴﺘﺄﺟﺮ‬
‫ﺑﺎﻟﺪﻳﻨﺎر‬
‫ ﻣﻠﻚ ﻟﻸﺳﺮة او أﺣﺪ‬.1
‫أﻓﺮادهﺎ‬
‫ ﻣﺴﺘﺄﺟﺮ دون ﻓﺮش‬.2
‫ ﻣﺴﺘﺄﺟﺮ ﻣﻔﺮوش‬.3
‫ ﻣﻠﻚ ﻷﺣﺪ اﻷﻗﺎرب‬.4
‫ ﻣﻘﺎﺑﻞ ﻋﻤﻞ‬.5
‫ دون ﻣﻘﺎﺑﻞ‬.6
(‫ أﺧﺮى )ﺣﺪد‬.7
119
××
×××
×
Type of Tenure
1.Owned by the
household or
one of its
members
skip to Q 119
2.Rented
Unfurnished
3.Rented
furnished
4.Owned by
a relative
5. For work
6.free
7.Other
(Specify )
skip to Q 119
|__|
:‫ﺍﻟﻘﻀـــﺎﺀ‬
‫ ﺒﻴﺎﻨــــــﺎﺕ ﻋـــــــﻥ ﺍﻟﻤﺴـــــــــﻜﻥ‬.2
117
‫ﻧﻮع ﺣﻴﺎزة اﻟﻤﺴﻜﻦ‬
119
106
116
‫ﻧﻮع اﺷﻐﺎل‬
‫اﻟﻤﺴﻜﻦ‬
‫ ﻣﺄهﻮل ﺑﺄﺳﺮة ﺧﺎﺻﺔ‬.1
‫ ﻣﺄهﻮل ﺑﺄﺳﺮﻩ ﺟﻤﺎﻋﻴﺔ‬.2
129 ‫س‬
‫ ﻓﻨﺪق‬.3
‫ ﻣﺴﻜﻦ ﻋﺎم‬.4
‫ ﺧﺎل‬. 5
‫ ﻣﻐﻠﻖ‬.6
‫ ﺗﺤﺖ اﻟﺘﺸﻴﻴﺪ‬.7
(‫ أﺧﺮى )ﺣﺪد‬.8
115
‫ﻧﻮع اﻟﻤﺴﻜﻦ‬
‫ دار‬.1
‫ ﺷﻘﺔ‬.2
‫ ﻓﻴﻼ‬.3
‫ ﺑﺮاآﻴﺔ‬.4
‫ﺧﻴﻤﻪ‬/ ‫ ﺑﻴﺖ ﺷﻌﺮ‬.5
‫ ﻣﻜﺎن ﻋﻤﻞ‬/‫ ﻣﺆﺳﺴﺔ‬.6
‫ ﺗﺤﺖ اﻟﺘﺸﻴﻴﺪ‬.7
(‫ أﺧﺮى )ﺣﺪد‬.8
114
‫رﻗﻢ‬
‫اﻟﻤﺴﻜﻦ‬
‫ﻓﻲ‬
‫اﻟﻤﺒﻨﻰ‬
113
‫اﺳﻢ ﻣﺎﻟﻚ أو ﻣﺴﺘﺄﺟﺮ‬
‫ اﻟﻤﺆﺳﺴﺔ‬/ ‫اﻟﻤﺴﻜﻦ‬
District
Sub-District
112
‫اﻟﺮﻗﻢ‬
‫اﻟﻤﺘﺴﻠﺴﻞ‬
‫ﻟﻠﻤﺒﻨﻰ‬
‫ﻓﻲ‬
‫اﻟﺒﻠﻮك‬
111
‫اﻟﺮﻗﻢ‬
‫اﻟﺪاﺋﻢ‬
‫ﻟﻠﻤﺒﻨﻰ‬
‫إن وﺟﺪ‬
101
102
103
110
‫اﺳﻢ اﻟﺸﺎرع‬
‫ورﻗﻤﻪ إن وﺟﺪ‬
‫ﺭﻗﻡ ﺍﻟﺴﻁﺭ‬
121
‫اﻟﻤﺼﺪر اﻟﺮﺋﻴﺴﻲ‬
‫ﻟﻤﻴﺎﻩ اﻟﺸﺮب‬
Monthly rent of the housing unit ( in JD )
‫ﻣﺴﺎﺣﺔ‬
‫اﻟﻤﺴﻜﻦ‬
‫ﺑﺎﻟﻤﺘﺮ‬
‫اﻟﻤﺮﺑﻊ‬
122
‫ﻣﺼﺪر اﻹﺿﺎءة‬
Duration of occupancy of housing unit ( in Years )
123
: ‫ﺍﻟﻠـــﻭﺍﺀ‬
131 ‫س‬
×
Type of
occupancy
1.Occupied by
private household
2.Occupied by
collective
household
3.Hotel
4.Public
housing unit
skip to Q 129
5.Vacant
6.Closed
7.Under
Construction
8.Other
(Specify)
skip to Q 131
×
Type of housing
unit
1.Dar
2.Apartment
3.Villa
4. Barracks
5. Hair tent /tent
6.Establishment/
work place
7.Under
construction
8.other ( specify)
××
×××
131 ‫ ﻓﻲ ﺤﺎﻟﺔ ﻋﺩﻡ ﻭﺠﻭﺩ ﻤﺴﺎﻜﻥ ﻓﻲ ﺍﻟﻤﺒﻨﻰ ﺍﻨﺘﻘل ﺇﻟﻰ ﺍﻟﺴﺅﺍل‬:‫ﻟﻠﺒﺎﺤﺙ‬
2. Housing Unit Information
|__|__|
Housing Unit No. in the building
|__|__|
105
Governorate
line No.
: ‫ﺍﻟﻤﻨﻁﻘﺔ‬
|__|__|
|__|__|
×××
Owner or
lessee Name of
housing unit
/establishment
×××××
Name of street and it's
Number ( If available )
.1
.2
.3
Building Permanent No. (If available )
Locality
:‫ﺍﻟﻤﺤﺎﻓﻅــﺔ‬
104
Serial No. of Building in the block
:‫ﺍﻟﺘﺠﻤﻊ ﺍﻟﺴﻜﺎﻨﻲ‬
|__|__|__|
.4
.5
.6
.7
.8
.9
10
11
12
13
14
15
‫ اﺟﻤـﺎﻟــﻲ ﺑﻴﺎﻧـــﺎت اﻟﺼﻔﺤﺔ‬.4
‫ﻣﺠﻤﻮع‬
‫اﻟﻔﻨﺎدق‬
×××
×××
147
146
‫ﻋﺪد اﻷﺳﺮﻓﻲ اﻟﺼﻔﺤﺔ‬
‫اﻷﺳﺮ‬
‫اﻷﺳﺮ‬
‫اﻟﺨﺎﺻﺔ اﻟﺠﻤﺎﻋﻴﺔ‬
×××
148
×××
145
144
143
142
‫ﻣﺠﻤﻮع‬
‫اﻻﺳﺮ‬
‫اﻟﻔﻨﺎدق‬
‫اﻟﺠﻤﺎﻋﻴﺔ‬
‫اﻟﺨﺎﺻﺔ‬
‫ﻣﺠﻤﻮع‬
‫اﻟﻤﺴﺎآﻦ‬
‫ﻣﺄهﻮل‬
‫ﺑﺄﺳﺮة‬
‫ﺟﻤﺎﻋﻴﺔ‬
××
××
××
××
××
××
‫ﻣﺄهﻮل‬
‫ﺑﺄﺳﺮة‬
‫ﺧﺎﺻﺔ‬
‫ﻏﻴﺮ‬
‫اﻟﻤﺄهﻮﻟﺔ‬
××
××
‫ﻋﺪد‬
‫اﻟﻤﺒﺎﻧﻲ‬
For Office
××
(
‫ﻟﻐﺎﻳﺎت اﻟﺘﺠﻬﻴﺰ اﻟﻤﻜﺘﺒﻲ‬
(
) ‫ﻋﺪد اﻷﺳﻄﺮ اﻟﻤﺴﺘﻮﻓﺎة‬
××
‫اﻟﻤﺒﻨﻰ‬
××
‫ ﻧﻌﻢ‬.1
‫ﻋﺪد‬
‫ﻣﻮاد اﻟﺒﻨﺎء اﻟﻐﺎﻟﺒﺔ ﻟﻠﺠﺪران‬
‫اﻟﺨﺎرﺟﻴﺔ‬
‫ ﺣﺠﺮ ﻧﻈﻴﻒ‬.1
‫ﻃﻮاﺑﻖ‬
‫اﻟﻤﺒﻨﻰ‬
××
Number of floors
1. Yes
2.No
Availability of elevator
Number of housing units in the building
Number of households in the building
‫ ﻟﻠﺴﻜﻦ ﻓﻘﻂ‬.1
‫ ﻟﻠﻌﻤﻞ ﻓﻘﻂ‬.2
‫ ﻟﻠﻌﺒﺎدة‬.3
‫ أﺳﻤﻨﺖ ﻣﺴﻠﺢ‬.3
‫ ﻟﻠﺜﻘﺎﻓﺔ‬/‫ ﻟﻠﺘﺮﻓﻴﻪ‬.4
‫ ﻟﺒﻦ أﺳﻤﻨﺘﻲ‬.4
‫ ﻣﺘﻌﺪد اﻷﻏﺮاض‬.5
‫ ﻃﻴﻦ وﺣﺠﺮ‬،‫ ﻟﺒﻦ ﻃﻴﻦ‬.5
‫ ﻣﻐﻠﻖ‬.6
‫ ﺧﺸﺐ‬،‫ زﻧﻚ‬،‫اﺳﺒﺴﺖ‬.6
‫ ﺧﺎل‬.7
‫ ﻗﻤﺎش‬،‫ ﺻﻮف‬،‫ ﺷﻌﺮ‬.7
(‫ أﺧﺮى )ﺣﺪد‬.8
‫ ﺗﺤﺖ اﻟﺘﺸﻴﻴﺪ‬.8
×
Type of dominant
materials of
Outside walls of
the building
Number of persons in the building
‫ﺻﻔﺔ اﺷﻐﺎل اﻟﻤﺒﻨﻰ‬
‫ ﺣﺠﺮ ﻧﻈﻴﻒ وأﺳﻤﻨﺖ ﻣﺴﻠﺢ‬.2
‫ ﻻ‬.2
×
135
1. Cut stone
2.Cut stone &
concrete
3.Concrete
4.Cement bricks
5.Mud bricks &
stone
6.Asbestos, wood
Zinc
7.Hair, wool, cloth
8.Other (Specify )
×
134
‫ﺳﻨﺔ‬
132
/ ‫اﺳﻢ ﻣﺎﻟﻚ اﻟﻤﺒﻨﻰ‬
‫أو اﺳﻢ اﻟﻤﺒﻨﻰ‬
131
‫أول ﻣﺴﻜﻦ‬
‫ﻓﻲ اﻟﻤﺒﻨﻰ‬
‫اﻟﻤﺒﺎﺷﺮة‬
‫ ﻋﻤﺎرة‬.1
‫ﺑﻮﺿﻊ‬
‫ ﻓﻴﻼ‬.3
‫اﻷﺳﺎس‬
‫ ﺑﺮاآﻴﺔ‬.4
‫ ﻧﻌﻢ‬.1
‫ ﻻ‬.2
‫ ﺧﻴﻤﻪ‬/ ‫ ﺑﻴﺖ ﺷﻌﺮ‬.5
‫ﻟﻠﻤﺴﻜﻦ اﻟﺘﺎﻟﻲ‬
‫ﻟﻠﻤﺒﻨﻰ‬
‫ دار‬.2
××××
130
129
‫ﻋﺪد‬
‫ﻋﺪد‬
‫ﻋﺪد‬
‫اﻷﻓﺮاد‬
‫اﻷﺳﺮ‬
‫اﻟﻐﺮف ﻓﻲ‬
‫ﻓﻲ‬
‫ﻓﻲ‬
‫اﻟﻤﺴﻜﻦ‬
‫اﻟﻤﺴﻜﻦ‬
‫اﻟﻤﺴﻜﻦ‬
128
127
‫ ﺒﻴﺎﻨـﺎﺕ ﻋـﻥ ﺍﻟﻤﺴــﻜﻥ‬.2
126
125
‫ﺗﻮاﻓﺮ‬
‫ﻣﻄﺒﺦ‬
‫ﻣﺴﺘﻘﻞ ﻓﻲ‬
‫اﻟﻤﺴﻜﻦ ؟‬
‫ﺗﻮاﻓﺮ‬
‫اﻟﻤﺮﺣﺎض‬
‫ﺑﺎﻟﻤﺴﻜﻦ‬
Total No. of rooms
In the housing unit
×
Type of building
1.Amara
2.Dar
3.Villa
4. Barracks
5. Hair tent /
tent
6.Establishment
7.Under
construction
8.Other
( specify)
‫ ﻧﻌﻢ‬.1
‫ ﻻ‬.2
‫ ﻧﻌﻢ‬.1
‫ ﻻ‬.2
‫ ﻣﻨﺸﺄﻩ‬/ ‫ ﻣﺆﺳﺴﺔ‬.6
124
‫ﻧﻮع اﻟﺼﺮف‬
‫اﻟﺼﺤﻲ‬
‫ﻣﺠﺎري ﻋﺎﻣﺔ‬
‫ﺣﻔﺮة اﻣﺘﺼﺎﺻﻴﺔ‬
(‫أﺧﺮى )ﺣﺪد‬
‫ﻻ ﻳﻮﺟﺪ‬
.1
.2
.3
.4
‫ ﻻ ﻣﺴﺎآﻦ‬.3
‫ ﺗﺤﺖ اﻟﺘﺸﻴﻴﺪ‬.7
(‫ أﺧﺮى) ﺣﺪد‬.8
Type of occupancy
1.Residential only
2.Business only
3.Worship
4.Recreation/
culture
5.Multi-purpose
6.Closed
7.Vacant
8.Under
construction
133
‫ﻧﻮع اﻟﻤﺒﻨﻰ‬
)
×
Name of owner of
the Building
or name of the
Building
×××
×
‫ﻏﺮف‬
‫اﻟﻨﻮم‬
‫اﻟﻤﺠﻤﻮع‬
×
××
×
1. Yes
2. No
×××
‫اﻟﻤﺒﻨﻰ‬
‫ﻓﻲ‬
136
Number of households in the housing unit
‫اﻟﻤﺒﻨﻰ‬
‫ﻓﻲ‬
137
Number of persons in the housing unit
‫ﻓﻲ‬
138
‫ﻋﺪد‬
‫ﻋﺪد‬
‫ﺗﻮاﻓﺮ‬
‫اﻟﻤﺼﻌﺪ اﻟﻤﺴﺎآﻦ اﻷﺳﺮ‬
1. Yes
2.No skip to next housing unit
3. No housing unit
‫اﻷﻓﺮاد‬
139
107
) ‫ﺭﻗﻡ ﺍﻟﺼﻔﺤﺔ‬
2. Housing Unit Information
First housing unit in the building
‫ﻋﺪد‬
140
Year of laying fundements of the building
141
‫ ﺒﻴﺎﻨــﺎﺕ ﻋـــﻥ ﺍﻟﻤﺒﻨــــﻰ‬.3
Block No.
Page No. (
No. of completed lines
3. Building Information
:‫ﺭﻗﻡ ﺍﻟﺒﻠﻭﻙ‬
|__|__|__|
‫ﻋﺪد اﻟﻤﺴﺎآﻦ ﻓﻲ اﻟﺼﻔﺤﺔ‬
‫رﻗﻢ اﻟﺴﻂر‬
‫ﻋﺪد اﻻﻓﺮاد ﻓﻲ اﻟﺼﻔﺤﺔ‬
149
×
1. Yes
2.No
150
Availability of Toilet in the housing unit
151
Availability of independent kitchen in the housing unit
152
Total
153
Bed rooms
154
×
Type of
sewage system
.1
.2
1.Public
network
2.Cess pool
3.Other
(Specify )
4.None
.3
.4
.5
.6
.7
.8
.9
10
11
12
13
14
15
‫اﻟﺨﺎﺻﺔ‬
‫ﻣﺠﻤﻮع‬
‫اﻟﻤﺴﺎآﻦ‬
×××
××
××
××
××
××
××
Collective households
142
‫ﻋﺪد‬
‫اﻟﻤﺒﺎﻧﻲ‬
‫ﻣﺄهﻮل‬
‫ﺑﺄﺳﺮة‬
‫ﺧﺎﺻﺔ‬
‫ﻏﻴﺮ‬
‫اﻟﻤﺄهﻮﻟﺔ‬
××
××
××
Number of Buildings
‫اﻟﺠﻤﺎﻋﻴﺔ‬
Occupied by
Collective household
Hotels household
143
Not-occupied
‫اﻟﻔﻨﺎدق‬
Total housing units
Total Persons
144
‫ﻋﺪد اﻟﻤﺴﺎآﻦ ﻓﻲ اﻟﺼﻔﺤﺔ‬
No. of housing units in the page
households
×××
145
‫ﻣﺠﻤﻮع‬
‫اﻻﺳﺮ‬
Private
×××
146
‫ﻣﺄهﻮل‬
‫ﺑﺄﺳﺮة‬
‫ﺟﻤﺎﻋﻴﺔ‬
households
×××
147
Total Households
‫اﻟﻔﻨﺎدق‬
148
‫ﻋﺪد اﻷﺳﺮﻓﻲ اﻟﺼﻔﺤﺔ‬
No. of households in the page
‫اﻷﺳﺮ‬
‫اﻷﺳﺮ‬
‫اﻟﺨﺎﺻﺔ اﻟﺠﻤﺎﻋﻴﺔ‬
‫ﻣﺠﻤﻮع‬
149
Private households
‫ﻋﺪد اﻻﻓﺮاد ﻓﻲ اﻟﺼﻔﺤﺔ‬
No. of persons in the page
150
private household
151
Collective
152
Hotel
153
households
154
‫ اﺟﻤـﺎﻟــﻲ ﺑﻴﺎﻧـــﺎت اﻟﺼﻔﺤﺔ‬.4
Occupied by
Total Information of the Page
:‫اﻟﺤﻲ‬
|__|__|
|__|__|__|
106
‫ ﺑﻴﺎﻧﺎت أﻓﺮاد اﻷﺳﺮة‬.2
‫اﻟﺤﺎﻟﻲ‬
‫ﻟﻼردﻧﻴﻴﻦ‬
‫وﻓﻲ‬
‫اﻟﻤﻤﻠﻜﺔ‬
‫ﻟﻐﻴﺮ‬
Types of Health
Insurance
‫هﻞ ﻟﺪى‬
(‫)اﺳﻢ اﻟﻔﺮد‬
‫رﻗﻢ وﻃﻨﻲ؟‬
‫ ﻨﻌﻡ‬.1
×
Place of residence of mother at the
Reason of
( Name of Locality & Governorate
birth of person
residence abroad
or Name of Country )
( Name of Locality & Governorate
( for Jordanians )
or Name of Country )
& Reason of
Current place of usual residence
incoming to
Jordan (for
Non-Jordanians )
1.Work
2.Study
×
For
Jordanians
×××
‫اﻟﻌﺴﻜﺮي‬
‫ﺟﺎﻣﻌﺎت رﺳﻤﻴﺔ‬
8 4 2 1
Nationality
Person
5.Treatment
‫ اﻹﺳﻼم‬.1
‫اﻟﻤﺴﻴﺤﻴﺔ‬.2
‫أﺧﺮى‬.3
‫ ذآﺮ‬.1
‫ أﻧﺜﻰ‬.2
‫ اﺑﻨﻪ‬/ ‫اﺑﻦ‬.2
‫ أﺧﺖ‬/ ‫أخ‬.5
×
××
‫ أﻗﺎرب ﺁﺧﺮون‬.6
××
×
×
Religion
Sex
insured
1.Muslim
1. Male
1.Yes
2.Christian
2. Female
2.No
3.Other
skip to 212
×
××
Relation to Head
of Household
1.Husband / Wife
2.Son / Daughter
3.Father / Mother
4.Grandson /
Granddaughter
5.Brother / Sister
Name ( Four Parts )
202
.2
.3
.4
.5
.6
7.Maid
8.Others
.7
0 = Household
×
.1
6.Other Relatives
Head
6.other (specify)
‫اﺳﻢ اﻟﻔﺮد‬
(‫)ارﺑﻌﺔ ﻣﻘﺎﻃﻊ‬
‫ ﺧﺎدﻣﺔ‬/ ‫ ﺧﺎدم‬.7
‫ﺁﺧﺮون‬.8
××××
203
‫اﻟﻌﻼﻗﺔ ﺑﺮب‬
‫اﻷﺳﺮة‬
‫ زوﺟﺔ‬/‫زوج‬.1
‫ﻻ اﻋﺮف‬.3
Know
4.Tourism
‫اﻟﺠﻨﺲ‬
204
‫ ﺣﻔﻴﺪﻩ‬/‫ﺣﻔﻴﺪ‬.4
national
3.Accompaniment
‫اﻟﺪﻳﺎﻧﺔ‬
205
‫ ﻻ‬.2
3.Don't
number
206
‫ أم‬/ ‫أب‬.3
discrete
2.No
Date of birth
Is (Name of
person
Medically
Has the
1.Yes
207
‫ﺗﺎرﻳﺦ‬
‫اﻟﻤﻴﻼد‬
‫اﻟﻤﺪﻧﻲ‬
××
Civilian
×××
Military
×××
Official universities
or Name of Country )
Duration of residence in current place ( for Jordanians ) and in
Jordan ( for Non-Jordanians ) in Years.
Previous place of usual residence
( Name of Locality & Governorate
××
208
←‫ ﻧﻌﻢ‬.1
212
‫ ﻻ‬.2
‫اﻻردﻧﻴﻴﻦ‬
×××
‫هﻞ )اﺳﻢ‬
‫اﻟﻔﺮد( ﻣﺆﻣﻦ‬
‫ﺻﺤﻴﺎ ﻓﻲ‬
‫اﻷردن؟‬
‫ﺧﺎص‬
‫ ﺍﺴﻡ ﺍﻟﺩﻭﻟﺔ‬:‫ﺨﺎﺭﺝ ﺍﻟﻤﻤﻠﻜﺔ‬
‫ أﻧﻮاع‬/‫ﻧﻮع‬
‫اﻟﺘﺄﻣﻴﻦ اﻟﺼﺤﻲ‬
‫اﻟﺠﻨﺴﻴﺔ‬
209
Population Category ‫ﻓﺌﺔ اﻟﺴﻜﺎن‬
‫ اﺳﻢ اﻟﺪوﻟﺔ‬:‫ﺧﺎرج اﻟﻤﻤﻠﻜﺔ‬
210
.8
.9
‫ اﻟﺴــــــﻜﺎن داﺧــــﻞ اﻷردن‬.1
‫ ﺍﺴﻡ ﺍﻟﺩﻭﻟﺔ‬:‫ﺨﺎﺭﺝ ﺍﻟﻤﻤﻠﻜﺔ‬
‫اﻟﻤﻜﺎن‬
211
Inside Jordan
‫اﺳﻢ اﻟﺘﺠﻤﻊ واﻟﻤﺤﺎﻓﻈﺔ‬:‫داﺧﻞ اﻟﻤﻤﻠﻜﺔ‬
‫ﻟﻸردﻧﻴﻴﻦ‬
‫ﻓﻘﻂ‬
212
10
401
Jordan
401
Jordan
401
Jordan
401
Jordan
‫ اﻷردﻧﻴﻮن ﺧﺎرج اﻷردن‬.2
‫ﺍﺴﻡ ﺍﻟﺘﺠﻤﻊ ﻭﺍﻟﻤﺤﺎﻓﻅﺔ‬:‫ﺩﺍﺨل ﺍﻟﻤﻤﻠﻜﺔ‬
213
Private
‫اﻟﻜﺎﻣﻠﺔ ﻓﻲ‬
102
District
‫اﻟﺮﻗﻢ اﻟﻤﺘﺴﻠﺴﻞ ﻟﻠﻔﺮد‬
‫ﺑﺎﻟﺴﻨﻮات‬
‫ ﺍﺴﻡ ﺍﻟﺘﺠﻤﻊ ﻭﺍﻟﻤﺤﺎﻓﻅﺔ‬:‫ﺩﺍﺨل ﺍﻟﻤﻤﻠﻜﺔ‬
‫ﺳﺒﺐ اﻹﻗﺎﻣﺔ ﻓﻲ‬
(‫اﻟﺨﺎرج )ﻟﻸردﻧﻴﻴﻦ‬
‫وﺳﺒﺐ اﻟﻘﺪوم اﻟﻰ‬
‫اﻷردن )ﻟﻐﻴﺮ‬
(‫اﻷردﻧﻴﻴﻦ‬
‫ ﻟﻠﻌﻤل‬.1
‫ ﻟﻠﺩﺭﺍﺴﺔ‬.2
‫ ﻟﻠﻤﺭﺍﻓﻘﺔ‬.3
‫ ﻟﻠﺴﻴﺎﺤﺔ‬.4
‫ ﻟﻠﻌﻼﺝ‬.5
(‫ ﺍﺨﺭﻯ )ﺤﺩﺩ‬.6
: ‫اﻟﻠـــﻮاء‬
|__|__|
Serial Number of Person
‫ﻣﻜﺎن إﻗﺎﻣﺔ اﻻم وﻗﺖ‬
‫وﻻدة اﻟﻔﺮد‬
101
Governorate
Jordanians Abroad
‫ﻣﻜﺎن اﻻﻗﺎﻣﺔ اﻟﻤﻌﺘﺎدة اﻟﺤﺎﻟﻴﺔ‬
214
104
Locality
‫ﺷﻬـــــــﺮ‬
215
‫اﻟﻤﺠﻤﻮع‬
‫ﻣﺪة اﻻﻗﺎﻣﺔ‬
216
:‫اﻟﻤﺤﺎﻓﻈــﺔ‬
|__|__|
Block No.
Total
‫ﻣﻜﺎن اﻻﻗﺎﻣﺔ اﻟﻤﻌﺘﺎدة اﻟﺴﺎﺑﻘﺔ‬
217
:‫اﻟﺘﺠﻤﻊ اﻟﺴﻜﺎﻧﻲ‬
107
Household members information
218
103
Sub-district
|__|__|__|
Neighborhood
:‫رﻗﻢ اﻟﺒﻠﻮك‬
:‫اﻟﻘﻀـــﺎء‬
|__|
Month
111
105
Area
‫ﺳــــــﻨﺔ‬
Building permanent No.
:‫اﻟﻤﻨﻄﻘﺔ‬
|__|__|
Year
:‫رﻗﻢ اﻟﻤﺒﻨﻰ اﻟﺪاﺋﻢ‬
|__|__|__|
110
Street name
‫اﻟﻌﻤﺮ ﺑﺎﻟﺴﻨﻮات اﻟﻜﺎﻣﻠﺔ‬
‫ ــــــــــــــــــــ‬:‫اﺳﻢ اﻟﺸﺎرع‬
Age ( in completed years )
|__|__|__|__|__|
‫ ﻓﻲ اﻟﻤﺮﺑﻊ‬X ‫ إذا اﺳﺘﻌﻤﻠﺖ اﺳﺘﻤﺎرة ﻣﻜﻤﻠﺔ ﺿﻊ إﺷﺎرة‬: ‫ﻣﻼﺣﻈﺔ ﻟﻠﺒﺎﺣﺚ‬
‫‪112‬‬
‫اﻟﺮﻗﻢ اﻟﻤﺘﺴﻠﺴﻞ ﻟﻠﻤﺒﻨﻰ ﻓﻲ اﻟﺒﻠﻮك‪:‬‬
‫|__|__|__|‬
‫‪Serial No. of the building in the block‬‬
‫‪113‬‬
‫___________‬
‫اﺳﻢ اﻟﻤﺒﻨﻰ‪ /‬اﺳﻢ اﻟﻤﺎﻟﻚ‪:‬‬
‫‪Building name / Owner name‬‬
‫‪114‬‬
‫اﻟﺮﻗﻢ اﻟﻤﺘﺴﻠﺴﻞ ﻟﻠﻤﺴﻜﻦ ﻓﻲ اﻟﻤﺒﻨﻰ‪:‬‬
‫|__|__|‬
‫‪Serial No. of the housing unit in the building‬‬
‫‪201‬‬
‫اﻟﺮﻗﻢ اﻟﻤﺘﺴﻠﺴﻞ ﻟﻸﺳﺮة ﻓﻲ اﻟﺒﻠﻮك‪:‬‬
‫|__|__|__|‬
‫‪Serial No. of the household in the block‬‬
‫(‬
‫رﻗﻢ اﻟﺼﻔﺤﺔ )‬
‫( ‪Page No.‬‬
‫)‬
‫‪ .2‬ﺑﻴﺎﻧــــــﺎت أﻓﺮاد اﻷﺳﺮة‬
‫‪219‬‬
‫‪203‬‬
‫‪221‬‬
‫‪220‬‬
‫‪223‬‬
‫‪222‬‬
‫‪225‬‬
‫‪224‬‬
‫‪227‬‬
‫‪226‬‬
‫هﻞ هﺬا )اﺳﻢ‬
‫اﻟﻔﺮد( ﻣﻠﺘﺤﻖ‬
‫ﺣﺎﻟﻴ ًﺎ او ﺳﺒﻖ ﻟﻪ‬
‫اﻻﻟﺘﺤﺎق ﺑﻤﺆﺳﺴﺔ‬
‫ﺗﻌﻠﻴﻤﻴﺔ؟‬
‫اﻟﺘﺤﺼﻴﻞ اﻟﻌﻠﻤﻲ‬
‫‪ .2‬ﺗﻠﻤﺬة ﻣﻬﻨﻴﺔ‬
‫‪ .1‬ﻧﻌﻢ‪ ،‬ﻣﻠﺘﺤﻖ ﺣﺎﻟﻴ ًﺎ‬
‫‪ .3‬ﺛﺎﻧﻮي‬
‫اﻟﺮﻗﻢ اﻟﻤﺘﺴﻠﺴﻞ ﻟﻠﻔﺮد‬
‫اﻟﺼﻒ ‪ /‬اﻟﺴﻨﺔ اﻟﺪراﺳﻴﺔ‬
‫‪ .2‬ﻨﻌﻡ‪ ،‬ﺴﺒﻕ ﻟﻪ‬
‫ﺍﻻﻟﺘﺤﺎﻕ‬
‫‪ .3‬ﻻ‬
‫‪ .1‬أﻣﻲ‬
‫‪ .2‬ﻣﻠﻢ‬
‫‪ .3‬اﺑﺘﺪاﺋﻲ‬
‫‪ .4‬إﻋﺪادي‬
‫‪ .5‬أﺳﺎﺳﻲ‬
‫‪ .6‬ﺗﻠﻤﺬة ﻣﻬﻨﻴﺔ‬
‫‪ .7‬ﺛﺎﻧﻮي‬
‫‪ .8‬دﺑﻠﻮم ﻣﺘﻮﺳﻂ‬
‫‪ .9‬ﺑﻜﺎﻟﻮرﻳﻮس‬
‫‪ 10‬دﺑﻠﻮم ﻋﺎﻟﻲ‬
‫‪ 11‬ﻣﺎﺟﺴﺘﻴﺮ‬
‫‪ 12‬دآﺘﻮراﻩ‬
‫‪ .1‬أﺳﺎﺳﻲ‬
‫‪ .4‬دﺑﻠﻮم ﻣﺘﻮﺳﻂ‬
‫‪ .5‬ﺑﻜﺎﻟﻮرﻳﻮس‬
‫‪ .6‬دﺑﻠﻮم ﻋﺎﻟﻲ‬
‫‪ .7‬ﻣﺎﺟﺴﺘﻴﺮ‬
‫‪ .8‬دآﺘﻮراﻩ‬
‫‪229‬‬
‫‪231‬‬
‫‪233‬‬
‫ﻟﻸﻓــــﺮاد اﻟﺬﻳــــﻦ أﻋﻤﺎرهـــــﻢ ‪ 15‬ﺳﻨــــﺔ ﻓﺄآﺜــــــﺮ ‪For person 15 years of age and over‬‬
‫ﺣﺎﻟﺔ اﻟﻨﺸﺎط اﻻﻗﺘﺼﺎدي ﺧﻼل اﻟﺴﺒﻌﺔ أﻳﺎم اﻟﻤﻨﺘﻬﻴﺔ ﺑﻠﺤﻈﺔ اﻟﻌﺪ )ﺧﻼل اﻷﺳﺒﻮع ‪(2004/10/1 –9/25‬‬
‫ﻟﻸﻓﺮاد ‪ 5‬ﺳﻨﻮات ﻓﺄآﺜﺮ‬
‫اﻟﻤﻨﺘﻈﻤﻮن ﻓﻲ اﻟﺪراﺳﺔ‬
‫اﻟﻤﺮﺣﻠﺔ‬
‫‪228‬‬
‫‪230‬‬
‫‪232‬‬
‫‪234‬‬
‫اﻟﺤﺎﻟﺔ اﻟﺰواﺟﻴﺔ‬
‫هﻞ ﻋﻤﻞ )اﺳﻢ‬
‫اﻟﻔﺮد( ﺧﻼل‬
‫اﻷﺳﺒﻮع‬
‫اﻟﻤﻨﺘﻬﻲ ﺑﺘﺎرﻳﺦ‬
‫‪2004/10/1‬‬
‫ﺣﺘﻰ وﻟﻮ ﺳﺎﻋﺔ‬
‫واﺣﺪة ‪:‬‬
‫‪.1‬ﻋﺎزب‪ /‬ﻋﺰﺑﺎء‬
‫‪ .2‬ﻣﺘﺰوج ‪ /‬ﻣﺘﺰوﺟﺔ‬
‫‪224‬‬
‫‪.3‬ﻣﻄﻠﻖ‪ /‬ﻣﻄﻠﻘﺔ‬
‫‪.4‬أرﻣﻞ‪ /‬أرﻣﻠﺔ‬
‫‪ .5‬ﻣﻨﻔﺼﻞ ‪ /‬ﻣﻨﻔﺼﻠﺔ‬
‫هﻞ آﺎن ﻟﺪى‬
‫)اﺳﻢ اﻟﻔﺮد(‬
‫ﻋﻤﻞ وﻟﻜﻨﻪ ﻟﻢ‬
‫ﻳﺰاوﻟﻪ )أي آﺎن‬
‫ﻏﺎﺋﺒﺎ ﻋﻨﻪ ﺑﺸﻜﻞ‬
‫ﻣﺆﻗﺖ( ﺑﺴﺒﺐ‬
‫ ﻓﻲ أي ﻋﻤﻞ‬‫ﻣﻘﺎﺑﻞ اﺟﺮ؟‬
‫اﻟﺘﺨﺼﺺ اﻟﻌﻠﻤﻲ‬
‫ أو ﻓ ﻲ ﻣ ﺼﻠﺤﺔ‬‫ﺧﺎﺻ ﺔ ﻳﻤﻠﻜﻬ ﺎ أو‬
‫ﻳﻤﻠﻚ ﺟﺰءًا ﻣﻨﻬﺎ؟‬
‫‪ -‬أو ﻓ ﻲ ﻣ ﺼﻠﺤﺔ‬
‫ﻟﻸﺳ ﺮة دون اﺟ ﺮ‬
‫)ﻣﺜﺎل‪ :‬آﺎﻟﻌﻤﻞ ﻓ ﻲ‬
‫ﻣﺰرﻋﺔ‪ ،‬ﺑﻘﺎل… ؟‬
‫ أو ﻓ ﻲ أي ﻋﻤ ﻞ‬‫ﺁﺧﺮ؟‬
‫اﺳﺘﻤﺮ‬
‫اﻟﻤﺮض‪ ،‬اﻹﺟﺎزة‪،‬‬
‫ﻋﻄﻠﺔ‪ ،‬ﺳﻔﺮ‪،‬‬
‫ﺗﻘﻠﻴﺺ اﻟﻨﺸﺎط ﻓﻲ‬
‫اﻟﻤﺆﺳﺴﺔ‪ ،‬ﺧﻠﻞ‬
‫ﻣﺆﻗﺖ ﻓﻲ‬
‫اﻟﻤﺆﺳﺴﺔ ﺧﻼل‬
‫اﻷﺳﺒﻮع اﻟﻤﻨﺘﻬﻲ‬
‫ﺑﺘﺎرﻳﺦ‬
‫‪2004/10/1‬‬
‫ﻣﺎ ﻣﺠﻤﻮع‬
‫ﺳﺎﻋﺎت‬
‫اﻟﻌﻤﻞ اﻟﻔﻌﻠﻴﺔ‬
‫اﻟﺘﻲ ﻋﻤﻠﻬﺎ‬
‫)اﺳﻢ اﻟﻔﺮد(‬
‫ﻓﻲ ﺟﻤﻴﻊ‬
‫اﻷﻋﻤﺎل ﺧﻼل‬
‫اﻷﺳﺒﻮع‬
‫اﻟﻤﻨﺘﻬﻲ‬
‫ﺑﺘﺎرﻳﺦ‬
‫‪2004/10/1‬‬
‫اﺳﻢ اﻟﻤﺆﺳﺴﺔ اﻟﺘﻲ ﻳﻌﻤﻞ ﻓﻴﻬﺎ )اﺳﻢ‬
‫اﻟﻔﺮد( ﺣﺎﻟﻴﺎ؟‬
‫اﻟﻨﺸﺎط اﻻﻗﺘﺼﺎدي اﻟﺮﺋﻴﺴﻲ اﻟﺤﺎﻟﻲ‬
‫ﻟﻠﻤﺆﺳﺴﺔ؟‬
‫ﻣﺎ أهﻢ اﻟﻤﻨﺘﺠﺎت أو اﻟﺴﻠﻊ واﻟﺨﺪﻣﺎت‬
‫اﻟﺘﻲ ﺗﻨﺘﺠﻬﺎ أو ﺗﻘﺪﻣﻬﺎ اﻟﻤﺆﺳﺴﺔ‬
‫اﻟﻤﻬﻨﺔ اﻟﺮﺋﻴﺴﻴﺔ اﻟﺤﺎﻟﻴﺔ؟‬
‫ﻟﻮ ﺗﻮﻓﺮت إﻟﻰ‬
‫)اﺳﻢ اﻟﻔﺮد(‬
‫ﻓﺮﺻﺔ ﻋﻤﻞ ﺧﻼل‬
‫اﻟﺴﺒﻌﺔ أﻳﺎم‬
‫اﻟﻤﻨﺘﻬﻴﺔ ﺑﺘﺎرﻳﺦ‬
‫‪ 2004/10/1‬أو‬
‫ﺧﻼل ال )‪(15‬‬
‫ﻳﻮﻣ ًﺎ اﻟﻼﺣﻘﺔ‬
‫ﻟﻬﺎ‪،‬هﻞ‬
‫آﻨﺖ‪/‬ﺳﺘﻜﻮن‬
‫ﻣﺴﺘﻌﺪا ﻟﻠﺒﺪء ﺑﺬﻟﻚ‬
‫اﻟﻌﻤﻞ؟‬
‫اﻟﺤﺎﻟﺔ اﻟﻌﻤﻠﻴﺔ ﻟﻠﻔﺮد‬
‫‪ .1‬ﻣﺴﺘﺨﺪم ﺑﺄﺟﺮ‬
‫‪ .2‬ﺻﺎﺣﺐ ﻋﻤﻞ‬
‫ﻣﻊ وﺟﻮد‬
‫ﻣﺴﺘﺨﺪﻣﻴﻦ ﺁﺧﺮﻳﻦ‬
‫‪ .3‬ﻳﻌﻤﻞ ﻟﺤﺴﺎﺑﻪ‬
‫دون وﺟﻮد‬
‫ﻣﺴﺘﺨﺪﻣﻴﻦ ﺁﺧﺮﻳﻦ‬
‫اﻟﻌﻤﻞ اﻟﺬي ﻳﻘﻮم ﺑﻪ‬
‫) اﺳﻢ اﻟﻔﺮد (‬
‫‪ .4‬ﻳﻌﻤﻞ ﻟﺪى‬
‫اﻷﺳﺮة دون اﺟﺮ‬
‫‪.5‬ﻳﻌﻤﻞ دون اﺟﺮ‬
‫اﻧﺘﻘﻞ‬
‫‪ -1‬ﻧﻌﻢ‬
‫اﻟﻰ اﻟﻔﺮد اﻟﺘﺎﻟﻲ‬
‫‪ -2‬ﻻ‬
‫ﺍﺴﺘﻤﺭ‬
‫‪.1‬ﻧﻌﻢ ←اﺳﺘﻤﺮ‬
‫ﺇﻟﻰ‬
‫ﺍﻟﻔﺭﺩ ﺍﻟﺘﺎﻟﻲ‬
‫‪.1‬ﻨﻌﻡ← ‪228‬‬
‫‪ .2‬ﻻ ← ‪232‬‬
‫هﻞ ﺑﺤﺚ )اﺳﻢ اﻟﻔﺮد(‬
‫ﻋﻦ ﻋﻤﻞ ﺑﺸﻜﻞ ﺟﺪي‬
‫ﺧﻼل اﻷﺳﺎﺑﻴﻊ اﻷرﺑﻌﺔ‬
‫اﻟﻤﻨﺘﻬﻴﺔ ﺑﺘﺎرﻳﺦ‬
‫‪2004/10/1‬؟‬
‫إذن‪ :‬ﻣﺎ ﻋﻼﻗﺔ )اﺳﻢ‬
‫اﻟﻔﺮد( ﺑﺎﻟﻨﺸﺎط‬
‫اﻻﻗﺘﺼﺎدي اﻟﺮﺋﻴﺴﻲ‬
‫ﺧﻼل اﻟﺴﺒﻌﺔ أﻳﺎم‬
‫اﻟﻤﻨﺘﻬﻴﺔ ﺑﺘﺎرﻳﺦ‬
‫‪ 2004/10/1‬؟‬
‫‪ .1‬ﻃﺎﻟﺐ‬
‫‪.2‬ﻣﺪﺑﺮ اﻟﻤﻨﺰل‬
‫‪.3‬ﻟ ﻪ‪/‬ﻟﻬ ﺎ دﺧ ﻞ أو‬
‫إﻳﺮاد‬
‫‪.4‬اﻟﻤﺮض‪/‬اﻟﻌﺠﺰ‪/‬‬
‫آﺒﺮ اﻟﺴﻦ‬
‫‪.5‬أﺧﺮى)ﺣﺪد(‬
‫‪.2‬ﻻ ← ‪234‬‬
‫‪-1‬ﻨﻌﻡ← ‪227‬‬
‫‪-2‬ﻻ ← ﺍﺴﺘﻤﺭ‬
‫‪.1‬‬
‫‪.4‬‬
‫‪.6‬‬
‫‪.7‬‬
‫‪.8‬‬
‫‪.9‬‬
‫‪10‬‬
‫‪Grade‬‬
‫‪.5‬‬
‫‪For person 5 Years of age and over : Has ( Name ) ever been to school‬‬
‫‪1. Yes currently enrolled‬‬
‫‪2. Yes ever enrolled‬‬
‫‪3. No‬‬
‫‪( 2 + 3 ) skip to 222‬‬
‫‪.3‬‬
‫‪Stage : 1. Basic education 2.Vocational apprenticeship 3. Secondary‬‬
‫‪4. Intermediate diploma‬‬
‫‪5. B.A, B.Sc‬‬
‫‪6. Higher diploma‬‬
‫‪7. M.A, M.Sc‬‬
‫‪8. Ph.D‬‬
‫‪.2‬‬
‫اﻟﺒﺎﺣــﺚ‪ :‬اﻧﺘﻘﻞ اﻟﻰ اﻟﺴﺆال ‪ 222‬اذا آﺎن ﻋﻤﺮ اﻟﻔﺮد ‪ 15‬ﺳﻨﺔ ﻓﺄآﺜﺮ واﻻ ﻓﺎﻧﺘﻘﻞ اﻟﻰ اﻟﻔﺮد اﻟﺘﺎﻟﻲ‬
‫××‬
‫اﻟﺒﺎﺣــﺚ‪ :‬اﻧﺘﻘــﻞ اﻟــﻰ اﻟﺴﺆال ‪ 224‬اذا آﺎن ﻋﻤﺮ اﻟﻔﺮد ‪ 15‬ﺳﻨﺔ ﻓﺄآﺜﺮ‪ ،‬واﻻ ﻓﺎﻧﺘﻘﻞ اﻟﻰ اﻟﻔﺮد اﻟﺘﺎﻟﻲ‬
‫×‬
‫××‬
‫×‬
‫××‬
‫‪Educational Status‬‬
‫×××××‬
‫×‬
‫‪Marital Status‬‬
‫‪Field of Study‬‬
‫‪1.Never‬‬
‫‪married‬‬
‫‪2.Married‬‬
‫‪3.Divorced‬‬
‫‪4.Widowed‬‬
‫‪5.Separated‬‬
‫‪1. Illiterate‬‬
‫‪2.Read &Write‬‬
‫‪3.Elementary‬‬
‫‪4.Preparatory‬‬
‫‪5.Basic education‬‬
‫‪6.Vocational‬‬
‫‪apprenticeship‬‬
‫‪7.Secondary‬‬
‫‪8.Intermediate‬‬
‫‪diploma‬‬
‫‪9.B.A‬‬
‫‪10.Higher diploma‬‬
‫‪11.M.A‬‬
‫‪12.Ph.D‬‬
‫‪1 to 6 skip to 224‬‬
‫×‬
‫×‬
‫) ‪Did ( Name‬‬
‫‪work during the‬‬
‫‪week ended in‬‬
‫‪October 1st‬‬
‫‪2004 even for‬‬
‫‪one hour :‬‬
‫‪- In any paid‬‬
‫‪work‬‬
‫‪- In a business‬‬
‫‪completely or‬‬
‫‪partially‬‬
‫‪owned‬‬
‫‪-In a business‬‬
‫‪owned by the‬‬
‫‪household‬‬
‫‪without‬‬
‫‪payment‬‬
‫‪-In any other‬‬
‫‪business‬‬
‫‪1.Yes to 227‬‬
‫‪2.No continue‬‬
‫) ‪Had ( Name‬‬
‫‪any job, but he‬‬
‫‪did not practice‬‬
‫‪it ( was‬‬
‫‪temporarily‬‬
‫‪absent ) due to‬‬
‫‪illness,‬‬
‫‪vacation,‬‬
‫‪holiday, travel,‬‬
‫‪reduction in‬‬
‫‪economic‬‬
‫‪activity,‬‬
‫‪temporary‬‬
‫‪breakdown in‬‬
‫‪the‬‬
‫‪establishment‬‬
‫‪during the week‬‬
‫‪ended in‬‬
‫‪October 1st‬‬
‫? ‪2004‬‬
‫××‬
‫‪Total no.‬‬
‫‪of hours‬‬
‫‪worked‬‬
‫‪by‬‬
‫) ‪(Name‬‬
‫‪in all‬‬
‫‪jobs‬‬
‫‪during‬‬
‫‪the week‬‬
‫‪ended in‬‬
‫‪October‬‬
‫‪1st 2004‬‬
‫‪ .235‬هﻞ ﻳﻌﺎﻧﻲ أي ﻓﺮد ﻣﻦ أﻓﺮاد اﻷﺳﺮة ﻣﻦ أﻳﺔ إﻋﺎﻗﺔ ؟‬
‫‪Does any member of the household suffer from‬‬
‫? ‪any handicap‬‬
‫‪1.Yes --to 236‬‬
‫‪2.No‬‬
‫‪3.Don t know‬‬
‫‪4.no answer‬‬
‫‪2+3+4 ---skip to section 4‬‬
‫‪ .1‬ﻧﻌﻢ‬
‫‪ .2‬ﻻ‬
‫‪ .3‬ﻻ اﻋﺮف‬
‫‪ .4‬ﻻ اﺟﺎﺑﺔ‬
‫‪237‬‬
‫‪238‬‬
‫رﻗﻢ ﺳﻄﺮ‬
‫اﻟﻔﺮد ﻣﻦ‬
‫س ‪203‬‬
‫إﺳﻢ اﻟﻔﺮد ﻣﻦ‬
‫س ‪204‬‬
‫ﺳﻤﻌﻴﺔ‬
‫و ‪ /‬أو‬
‫ﻧﻄﻘﻴﺔ‬
‫‪1‬‬
‫ﺟﺴﺪﻳﺔ‬
‫و ‪ /‬أو‬
‫ﺣﺮآﻴﺔ‬
‫ﺷﻠﻞ دﻣﺎﻏﻲ‬
‫ﻋﻘﻠﻴﺔ‬
‫ﺑﺼﺮﻳﺔ‬
‫إﻋﺎﻗﺔ‬
‫ﻣﺘﻌﺪدة‬
‫أﺧﺮى‬
‫) ﺣﺪد (‬
‫‪2‬‬
‫‪3‬‬
‫‪4‬‬
‫‪5‬‬
‫‪6‬‬
‫‪7‬‬
‫اﻧﺘﻘﻞ اﻟﻰ ‪236‬‬
‫اﻧﺘﻘﻞ اﻟﻰ اﻟﻘﺴﻢ اﻟﺮاﺑﻊ‬
‫|__|__|‬
‫‪ .236‬ﻋﺪد اﻷﻓﺮاد ذوي اﻹﻋﺎﻗﺔ‬
‫‪Number of handicaped persons‬‬
‫‪Line‬‬
‫‪no.‬‬
‫‪from‬‬
‫‪203‬‬
‫‪Name from 204‬‬
‫‪Deaf or‬‬
‫‪Dumb‬‬
‫‪Physical‬‬
‫‪Cerebral‬‬
‫‪palsy‬‬
‫‪Mental‬‬
‫‪skip to next person‬‬
‫‪Other‬‬
‫‪(specify‬‬
‫) ‪Did ( Name‬‬
‫‪actively search‬‬
‫‪for work during‬‬
‫‪the 4 weeks‬‬
‫‪ended in‬‬
‫‪October 1st 2004‬‬
‫‪The relationship‬‬
‫‪of ( Name ) with‬‬
‫‪major economic‬‬
‫‪activity during‬‬
‫‪the 7 days ended‬‬
‫‪in October 1st‬‬
‫‪2004‬‬
‫‪1.Yes‬‬
‫‪next person‬‬
‫‪2.No‬‬
‫‪1.Yes‬‬
‫‪234‬‬
‫‪Kind of handicap‬‬
‫‪Visual‬‬
‫‪1.Paid Employee‬‬
‫‪2.Employer‬‬
‫‪3.own-account‬‬
‫‪worker‬‬
‫‪4.unpaid family‬‬
‫‪worker‬‬
‫‪5.unpaid worker‬‬
‫‪If a job was‬‬
‫‪offered during‬‬
‫‪the 7 days‬‬
‫‪ended in‬‬
‫‪October 1st or‬‬
‫‪in the next 15‬‬
‫‪days , would‬‬
‫‪( Name ) be‬‬
‫‪prepared to‬‬
‫‪start the job‬‬
‫‪continue‬‬
‫‪2.No‬‬
‫‪1.Yes to 228‬‬
‫‪2. No to 232‬‬
‫‪Multiple‬‬
‫‪handicap‬‬
‫‪Name of establishment in‬‬
‫‪which the person works‬‬
‫‪Major current economic‬‬
‫‪activity of the establishment‬‬
‫‪Major current occupation‬‬
‫‪Employment status‬‬
‫×‬
‫‪continue‬‬
‫‪ .3‬ﺑﻴﺎﻧﺎت ﻋﻦ ذوي اﻻﺣﺘﻴﺎﺟﺎت اﻟﺨﺎﺻﺔ‬
‫‪ .239‬ﻧﻮع اﻹﻋﺎﻗﺔ‬
‫×‬
‫××××‬
‫××××‬
‫×‬
‫×‬
‫×‬
‫‪1.Student‬‬
‫‪2.Housemaker‬‬
‫‪3.With means‬‬
‫‪4.Disabled‬‬
‫‪5.Other (specify‬‬
‫ اﺳﺄل ﻋﻦ اﻟﻌﺪد‬، ‫ هﻞ ﻳﺘﻮاﻓﺮ ﻟﺪى اﻷﺳﺮة أي ﻣﻦ اﻷﺟﻬﺰة أو اﻟﺨﺪﻣﺎت اﻟﺘﺎﻟﻴﺔ؟ وﻓﻲ ﺣﺎﻟﺔ ﺗﻮاﻓﺮ اﻟﺠﻬﺎز‬.4
Does the household have any of the following appliances or services? if available ask for the number
* ‫اﻟﻌﺪد‬
No.
×
‫ﻻ‬
‫ﻧﻌﻢ‬
No
Yes
2
1
Telephone
2
1
Mobile
2
1
Computer
2
1
‫ اﻟﺨﺪﻣﺎت‬/ ‫اﻷﺟﻬﺰة‬
Appliances / Services
* ‫اﻟﻌﺪد‬
No.
‫اﻟﺮﻗﻢ‬
‫ﻻ‬
‫ﻧﻌﻢ‬
249
2
1
‫هﺎﺗﻒ ﻧﻘﺎل‬
250
2
1
‫ﺣﺎﺳﻮب‬
251
2
1
252
2
1
‫اﺷﺘﺮاك إﻧﺘﺮﻧﺖ‬
‫اﻟﺮﻗﻢ‬
If the number is 8 or more enter 8
Solar heater
‫ﺳﺨﺎن ﺷﻤﺴﻲ‬
Gas cooker
‫ﻏﺎز‬/‫ ﻃﺒﺎخ‬/‫ﻓﺮن‬
Microwave
‫ﻣﻴﻜﺮوﻳﻒ‬
Private car ‫ ﺑﻚ أب‬/‫ﺳﻴﺎرة ﺧﺎﺻﺔ‬
/ pick up
* ‫اﻟﻌﺪد‬
No.
‫ﻻ‬
‫ﻧﻌﻢ‬
245
2
1
246
2
1
247
2
1
248
2
1
2
1
×
‫هﺎﺗﻒ ارﺿﻲ‬
Internet access
Appliances ‫اﻷﺟﻬﺰة‬
×
8 ‫ ﻓﺄآﺜﺮ ﺳﺠﻞ‬8 ‫* إذا آﺎن ﻋﺪد اﻷﺟﻬﺰة‬
Appliances ‫اﻷﺟﻬﺰة‬
Radio /
tape recorder
Television
‫ ﻣﺴﺠﻞ‬/‫رادﻳﻮ‬
Satellite
‫ﺳﺘﻼﻳﺖ‬
Refrigerator
‫ﺛﻼﺟﺔ‬
Washing machine
‫ﻏﺴﺎﻟﺔ‬
Summary information of the household members ‫ ﻣﻠـﺨﺺ ﺑﻴﺎﻧﺎت أﻓﺮاد اﻷﺳﺮة‬.5
265
264
263
262
261
260
259
258
257
256
255
254
253
‫اﻟﺴﻜﺎن اﻷردﻧﻴﻮن ﺧﺎرج اﻷردن‬
‫اﻟﺴﻜﺎن داﺧﻞ اﻷردن‬
‫ﻋﺪد اﻷﻓﺮاد‬
‫ﻧﻮع اﻷﺳﺮة‬
Jordanians abroad
Population inside Jordan
Number of persons
Type of household
Non- Jordanians ‫ﻏﻴﺮ أردﻧﻴﻴﻦ‬
‫ﻣﺠﻤﻮع‬
‫اﻧﺎث‬
‫ذآﻮر‬
Total
Female
Male
××
××
××
Jordanians
‫أردﻧﻴﻮن‬
‫ﻣﺠﻤﻮع‬
‫اﻧﺎث‬
‫ذآﻮر‬
‫ﻣﺠﻤﻮع‬
‫اﻧﺎث‬
‫ذآﻮر‬
Total
Female
Male
Total
Female
Male
××
××
××
××
××
××
‫ﻣﺠﻤﻮع‬
‫اﻧﺎث‬
‫ذآﻮر‬
Total
Female
Male
××
××
××
‫ﺗﻠﻔﺰﻳﻮن‬
Private
Collective
Hotel
‫ ﺧﺎﺻﺔ‬.1
‫ ﺟﻤﺎﻋﻴﺔ‬.2
‫ ﻓﻨﺎدق‬.3
×
‫اﻟﺮﻗﻢ‬
240
241
242
243
244