3-Sex
......
nate
'FCMlC
.
&-)(onth and year of birth
hth
Year
5-Ethnic group
Kinh
Other than Kinh
.
---
1.-
........
specify
Yes
:
No
B-a/SchooL attendance or
equivalent
II
trade
-.
c
.
........
I
..........
I
--
......
I
2
- 43I
Technical worker vith certificate
Technical worker no certificate
Hiddle vocational education
College / university degree
Post-graduate
b/ Field of study
I
......
........
Grade
......
I
.
Attending nou
*
Attended in the past
Never attended
*
bhigliest grade completed
b
11
-4
.-
Abroad'
7-Literacy
......
.......
I
- 51
-6
......
- - -.
-5
Uorked 6 months and over
-1
Vorked permanently less then 6 lnpnths - 2
Uorked temporarily less than 6 months - 3
Unemptoyed
- 45
Student
6
Household duties
.?
Inva1 id,
Other
-8
--..........
Separated
1 '
.
11-Usual activity i n Last
12 m t h s
*
' I
I
.......
,
12-win occupation
13- a/ N a m e of establishment
. uharc perron works
b/ Function,product of
ertablishment
c/.secior of industry
a/
..........
s
. .
*
t
I
I
I
I
--
......
I
--
'
19
.
.
I
II
.
.
t
born ,alive4 '
* .
e-?,
mnth i'nd yerr -dM y w r
e- M t h '
"last birth occur
Year
iT~ar,.i$i &,or a girl
1: BOY
1
Girl
g-ï,thaj chil,! ti(ii9rw
g- yes,stilt living
Mo, d i d
,
r
* I
I
.
I
a-
.
.......
,
.. .....
. .
b- . . . . . . . . .
c- . . . . . . . .
d- . . . . . . . . .
ß-Hou meny of your children Live
with you
b - h ?ny of your .children l i v e
s .
,
* clreuhere
c-& many of your children not
'
living
d-Total r W a r of children ever
I
I
...........
c/ . . . . . . . . . . . .
ob/
I
......
,7
----
I
.
*
89.
.
1
2
- 34
-
.......
'.
I
I
I
I
'I
1-full luw of each usual
residant In thi8 h?us.hold
2-Relationshipto the h e d
of houschold
-4
.
Child
Father I Rother
Grand child
Other tniiy'relmtlve
Mon fuily relation
......
-5
-7
L
3-sex
4-Nonth and year of birth
--
llonth
Yrar
5-Ethic group
-1
I
CDR PERSOWS BORN ON
,.
.
-
The s u e district
1
Another district of the same province
2
Nut of the district
Another province
-3
NOW of t h province
Abyd
-.
.....
......
.-.-
. .....
1
7 4 1teracy
......
. -2
--
........
6-Place uhem usually lived on
1-4-1984(
!
?
e
Siyrars agn)
.......
I-.--
Ki&
Other'than Uinti
specify
. ',-
,
-
.......
I
Yes
Ho
-2
-3
Attended in the p r s t
-Neverattended
b/Highrst grde coaplete?,
.
I
-'6
* .
--
........
Grade
.
..:...
.......
FOR PERSONS BORN ON
J
-I
9- al Highest qualification or
t rute
Technical wrkrr no c e f t i f w t e
.
Post-gradqatc
10-hrttaL statw
Single
Ikrrird
.
Uldovtd'
Divorced
Stprated
ll-Uyl
-4
-5
-6
'
-1
*
'
-2
-3
'4
5 .
-
activity in last
Uorked 6 .ontht and over
-1'
12 D0ntll.s ' Uorked permanently l e s s than 6 k t h s ,_ 2
Uorked temporarily lesa Jhan 6 rronthr
3
-
-6
Household duti e s *
hvalid
,
Other
...
.
13- a / Haw of establishaent
.
where person works
bl Function,prpJuct of
establishaent
CI Sector of industry
.
~~
-- 7
8.
.........
12-Min occupation-
........
........
c/ . . . . . . . . .
a/.
bl
. ---
-
.
----
-
~
14-ALL WEN .BORN FRC
a - w uny of your children Liva
with you
b-Hov bany of ydr children live
*
elsewhere
0-16 thst child living now
'
Girl
g-'Yes,still living
No, died
-. 4
70
......
. .. .' . . .
---
..........
b/ field of study
-3.
'
nlddle 'vochtioneleducation
College I wliversity-degree
......
......
I
......
. . . . .
II
HOUSING CENSUS FORM
Prwince
.......*.........................
*
Dism.ct
Caninraie
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
... .., ..:. . . . . ..... .. .. .
N a i m of head’s liarselidd
U
ED
....... ... .... ... ... .
r]
....... ...... D
m
. ........ * u
... .. .. ..
n
iriunbcfi
.
H a ~ k l i d di,ru,;ber
.*
Taalpcrsats iii harseltdd
Tad feiriales iii liarselidd
1. Type of housing
a- Pe@
t &-
(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)
2. Living areas (Spm)
(Bed room, diner rodm, waiting m m ete)
m1
.
3. Housing conveniences :
a H%er siyply :
b. Electricfcx liglitbig
- Piped inside of house
- Piped outside of house
- Well
- Other
U
U
4
- Yes
- NO
CI
U
1
2
1
2
:3
c- Tci!et facilities :
- Yes
- NO
1
2
3
4
5
* Toilet with flushing facilities
-_
* Double tank
.-_-
* Other
4; Type of ownership
- State sector
- Private sestor
- Collective and Religion sector
u3
- Others
04
6. Year and period of construction :
5 Before 1954
- From
01
‘2
o
1954-1960
1961-1975
1976-1980
1981-1985
c13
u
4
0
5
0
7
DG
1986
1987
08
1988
1989
*o
9
Date
Sign of Enumerator
Month
Year 1989
Sign of head’s household
76
. .
5 .
lhlk
dn&
....
ngok
.m
O
LQ..
Id Lbl CAC CAU tídl SAU.
I.
....
a/ . . . . . . . .
..........
ddnvl-
.....
d Tliiri!ipl?An klrili IÖ
cr..::..
w. .
.......
. . .
. . . .
....
*
.u
. . .
-
CØ
. .
. . . .
...a
-
G l . :
. . .*o
14. TATCÀ NHGNC PHU NÜ SiNH lÙ 1 4.1339 Dgt4'3t - 3 1974 (TÙ 6 D f N 4 9 Tubl) TR'A LÕ1 C
.... D
I
bl CÁC CAU 1161SAU-
,
*
......
....
*d...-. . . .
JI.
b l . .
dl..
.... *E3
etrnhlnO
Nlm
I/Ttd
o II
19
I
tiEU Cd GHI MUC 15
I
I
1
1
'
a
O
g r a n rdno
o1 dlk
r
I
U
l
U 2
o3
u 4
J
PHIEU DÃNG
Hovdtêttcltriliô:
Dia chi ciìa ha :
6
NHÀ
...... ... ........ .. .. O'
[I]
.........................
. ... . ... . . .. . .. .. ... . .... ........
Higcti, qiigti, tlii.uri : ... . . . ... . .. . ... . . . ... .. ... .. . ..
@a
Tinli, tlidtih plid:
xã,phrr&tg :
~
=
1 7 1
..
....... .......... .. .............
.. . . .. . . . . . .. . . . , . . . . . . . . . . . .. . . .
I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
bdn sb:
HOsb:
T&gabl*~r¿ifruisr*~:.
..... ..-.. ..
T&g sbt i3trw igIi (3 :
....,..... . . ..
1. Lu$ nhà dang a
D
00
'
a) Nhà kien ca' (bi$t thv, nhh cao hng, nhh mái bhng)
ci1
b).Nhh bán ki8n ca' (nhà t & n g xay, &, d i ngói, mái tan)
u 2
c) CQcl+i nhà khác (amnhà g6, tre, feu, lán t q i ...)
u3
2. Di+ tích ¿3 (mét vutmg)
m
(bao &m dien tích dùng d6 an, ng& tigp khách v.v)
. Tien nghi nhà a
i
ci1
a) Ngribt ,ivdc
- NU'& máy VAO nh8
- NU& d
y ci3ng @ng
u 2
133
- NU& g i h g xay
- Các l+i khác
u
4
b) Ndtig l i p i g tlidp shtig :
- Có dien
- m a n g cíj dien
01
02
c) Cd d i d t*êsidi ribig kli alg ?
- có
- mang
+ Nhà xí t$ h+i và bán t$ hoai
+ Nhà xí hai n@n
+ Cácloai khác .
,
1
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
- Nhà chtb x-6 ng&n
5. N(lun x%y d e g nhà
U '
c12
th6 Mn gino
1 1 3
e14
sÛ hini
:'
- Tx~fdcnilm 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
ghi ró hr, t&n)
ChÛ ho
(e,