STRICTLY CONFIDENTLAL
EA NO..............................................................
VILLAGE OR LOCALITY................................
REPUBLIC OF SIERRA LEONE
CHTEFDOM .......................................................
POPULATION CENSUS 1974
1
Serial N9
HOUSEHOLD NO.............................................
1
PEREONS
ALL
POR
FOR ALL FEBIM..=
Is
NAME
II
State Relationship
to Head and Other
M e rn b e r s ofths
Household
AGE
NATIONALIIY
OR
Stat:
age rn
Cornplsted
Yam
For Slcrra Leoncans
BIRTH
TRIPE
State Tribe for
Non-sierra Leoncans
State Nationahty
Prna
Ifborn in Sierra
Leone Statc Chiofdom of birth. If born
outside Sierra Leotre
State Country o f
Buth
RESIDENCE
How h g has hel
she been living in this
Chiefdom? State
Completcd yenrs.
--State
Highest
Classor
Form
ittended
Statc if
at s h o o
left
School
or
ATHER
L U V E?
m
OR
NO
Occupation
Ind ust ry
State kind ofjob
done in the last
Twelve hlonths
State kind of Business or
Product
Employment Status
State whether
Private Employcc
Government Employed
Night?
1
were
elsewhere
1st
, night?
have
died?
Is
the
last
D a k &Birth
born
child
Stlll
alive 7
Never
been to
Ye0
or
No
school
0’)
(d)
;i:
AGED 12 AND OVER
(r)
-
-
Month
(1)
-
l
l
I
Date of EIEurnesation.....................................................
.
Etiuriierator’s Sigilatuire..........................................
i
I
Supervisor’s Signature.. .........................................