II .A-1
1- 15
1. Govgrnorate
:
2. District
:
F
T
5. Town/Village Codp :
Town
Name :
V i l l a g e Name :
b. Ekundary
3. S u b - d i s t r i c t :
7. Block No.
4. Nahia
8. Page
6-8
9. S t r m t Kam-
Code :
:
-
mlo-19
No.
HOUSING WIT INFW'JATION
12
13
Type o f
Pcnnanmt
No.
14
Name of
hilding
or suner
15
16
17
No. of
20
21
22
2.3
24
ROMS
S e r i a l No. Serial No.
o f k u s i n s D f House-
Type o f
Housing
U n i t With- h o l d Vlithii
Mit
i n Block
18-20
XXX
Black
Type o f
Cccuponcy
T y p e of
Ounrv-ship
Typr o f
Hmtim
Tyor' ol
Illimi nat i o
1I.A-2
Emmerutor : I f * Y e s " or " No IIam%rgMts.* i n Question31, Continue
f o r Other Questions
Kcyrr:
II
KUSINE UNIT IffCt?MATI(IV( CONTO. )
25
Type of
scrrago
26'
II
30
32
31
-
For the F i r s t t i n 5 i n the Pge,Continue K c y i n g
B U R O I N G IESFSNATICN
33
34
35
bilding
Telaphone
kai lebi 1:
Liaterials
E
I
-
(
36
37
11.51
4.
2.
Matrict
3.
Cub-district:
:
El2
Nah10
Tom
:
mg
U
:
V'llago :
b.
Bounderycode
7.
Olock No.
:
m
l
o
1
3
9.
10
Placa o f P r o s e n
U w a l Aesidaro
I
Street
&E
:
Street Cmws No. :
-
kix-