FORM A I
HOUSEHOLD
CONFIDENTIAL
GOVERNMENT OF GHANA
I970 POPULATION CENSUS
ENUMERATION AREA No.
NAME OF TOWN/VILLAGE
DETAILED ADDRESS OF HOUSE OR COMPOUND
CU
SERIAL No. OF HOUSEHOLD WITHIN HOUSE
LIST A.USUAL MEMBERS PRESENT
Relationship to head of household
Sex
No.
Surname
Other Names
I
2 I
1
3
4
Total number
o f usual
members on
ìIST A
1
* I
LIST B. VISITORS PRESENT
4
Sex
No.
Other Names
Surname
Relationship to head
of household
Usual Residence
1
Village/Town
Local Authority
I
Total number of
visitors on
LIST B
o
2
3
4
Total of
LISTS A and 6
un
5
6
I
1
I
Full Name
Surname
1
Sex
Other Names
Age
I
Relatiorship to head
of household
Present Address
4
LIST Of- RELATIONSHIPS TO BE SPECIFIED
HEAD-(WIFE OR HUSBAND)
SON OR DAUGHTER
FATHER OR MOTHER
FATHER'S BROTHER OR SISTER
MOTHER'S BROTHER OR SISTER
BROTHER
SON'S CHlLDRtN
SISTER
DAUGHTER'S CHILDREN
BROTHER'S SON OR DAUGHTER
SISTER'S SON OR DAUGHTER
OTHER (sPECrf Y
F I L L T H I S QUESTIONNAIRE FOR ALL PERSONS WHO WERE PRESEN
PUT A CROSS IN THE APPROPRIATE BOX o
ANSWER ONLY FOR PERSCNS 6 YEA
ANSWER FOR EACH PERSON
3
4
AGE
?ELAT I ON SH I 1
In
com>I e ted TO HEAD OF
years HOUSEHOLD
6
N A T I ONALITY
7
;ULL- TIME EDUCATI
What i s y o u r
nationality?
Ca \
(b)
Have you khat is the h i b e s t
a t tended
or are you type o f school you
a t tending jl t tended?
school now?
5
BIRTHPLACE
Where w e r e you b o r n ?
on1y
~~
O0
1................................ 1-1
I ]
I n t h i s town/village
A;;tk;:nown/vi
11age
HEAD
o
Ghana
n Never
10 I-1'
3
..................
Other spec f y
t3
I n t h i s town/village
Ghana
...............................
S p e c i f y town/village,Region
1
...............................
e
m
~
.
~
~
e
.
.
o
.
e
e
m
m
~
e
1-1
m
m
e
e
.
~
m
e
m
e
m
m
~
m
e
m
m
m
e
m
~
m
~
Speci f y town / v i 11age, Regi on
I-]Outside
~
fy
b
Never
m
m
~
. m .
e
e
m
F
I
~
e
'
e
o
~
~
m
.
.
m
~
.
e
m
m
i 1
~
.
.
m
.
~
O u t s i d e Ghana
-[I
-[I
....
6
~ . . e . e . m . . . . . . . m a m . . ~ e m e m ~
peci f y country
m
1-1
a
.
1Femal
]
0 I
[ I M i ddl e
U
Other
.................
O0
I n t h i s town/village
eclfv
1
Ghana
Another town i v i 11 age
i n Ghana
Never
[I]
......... 1-1 Other
n
1 l o u t s i d e Ghana
. S ......................... .................
country
peci
1-1 I n t h i s t o w n / v i l l a g e
Ghana
town / v i 11 age
J-[ .Another
i n Ghana
H i d d 1e
r e . ~ m * m . . m . e . e
tfv c
1-
I-Iln
8
ñ
Femal
t h i s town/village
Speci f y town / v i
[-loutside
Ghana
Other
age, Region
11 Femal
Another town / v i 1 1 age
i n Ghana
..............................
peci
town / v i 1 1age, Regi on
fy
crji..........................
r i I n ai;
1 1
J1-
Ghana
Other
¡ ddl e
Secondary
O
Never
0 Past
1-'
Primary
2 1 ] M i ddl e
91-1
Secondary
*(Wever
Past
2
r
l
t
4
ddli
e
]-I
3
Secondary
.Other
. specify
8
trv
tZ/village
Another town / v i 1 1age
in Ghana
M
S p e c i f y countr)
Outs I de Ghana
caai fv
Pr i mary
...................
Other s p e c i f y
1
..............................
I-[
11
................
..........................
O0
I
]
I n t h i s town/village
3
-[I
O0
1
]Ghana
U
1U
tr,
I
S p e c i f y country
9
1
Other
fy
Secondary
.................
Other s p e c i f y
u
...............
Spec i
coun
Another t o w n / v i l l age
i n Ghana
3n
O
o
311-
fi
S p e c i f y country
P r im a r y
Never 1
~
fy
7
Secondary
.................
Other speci f y
Qp ec I f y town /v i 1 iage, Reg I on
3
i dd 1 e
1-1
Other
S p e c i f y country
O0
)
Ghana
Spec i fy town / v i 11age, Reg i o n
d
1[-]Primary
.
Ghana
Anothe r town/\li 11 age
i n Ghana
-
2M
I-[
m
e m . e e e m e m m m m . ~ e .
5
Seco nda ry
................
Other spec i
a
Ghana
1-1
~
~
O
IL
Another town / v i 11 age
i n Ohana
~
1-
................
S p e c i f y country
m
P r i mary
*FlMiddle
Other
Specify country .
I n t h i s town/village
i-[
~
.
'I-'
Ghana
n
town /v i 1 1 age, Reg ion
F l o u t s i d e Ohana
.
.....................
Other spec i f y
O0
1-
r l l n t h i s town/village
Another t o w n / v i l l a g e
i n Ghana
~
1Secondary
U
................
S p e c i f y countr)
Spec i f y c o u n t r y
id d l e
3
Other
I
m
['-IM
5
O u t s i d e Ghana
~
a Secondary
i
Another t o w n / v i l l a g e
i n Ghana
. Spec i f y
Mi ddl e
Past
Other
Spec i f y town /v i 11 age,Reg i or
Outside Ohana
..........................
Specify country
, 3
Primary
1-
21
8 .
* e . Cm*
Fiddle
Other
................
Spec i f y country
-
3
Secon d Lt r y
................
Other speci
fy
I
I N THE HOUSEHOLD ON CENSUS NIGHT (LIST A AND L I S T B ) .
WRITE THE ANSWER ON THE DOTTED LINE
ANSWER ONLY FOR PERSONS AGED 1 5 YEARS AND OVER
TYPE C
il
u
1
4
0
2
5
ANSWER CNLY FOR PERSCNS WHO WORKED FOR AT LEAST @IE W Y UURING 'IHE LAST 4 WEEKS
ACT1 V I TY
(b\
(a)
I F NO
Did you do any
{ow were you
work f o r a t
l e a s t one daj nainly occupied
during the
during the l a s t
l a s t 4 weeks:
4 weeks?
grade you
a t tained?
I
8
1 i
1-1
1
9
INDU
OCCUPATI ON
(a1
I F YES ( t o 8 a ) Name and
Add res s
Nhat kind of wor' o f e s tabl i shwhere
you
ment
did you do?
worked
YES
(b)
Bain product o
service o f thi
es tabl i shment
.................
..................
................
................
. ............
Nme
1
U
"O
.................
Other sDeci f v
2rl
Homemak e r
Address
Name
emp 1O Y ed
3[-]Un
....e
.................
11
TRY
Address
Other speci f y
EMPLOYMENT STATUS
21-j
Sel f-employed
31-
Self-employed w i t h o u t o t h e r employees
4 1 7 Unpaid family worker
.......................................
Other s p e c i f y
.
1
il
Employee
.
-1
21-1
Sel +employed and employs o t h e r s
91
Self-employed w i t h o u t o t h e r employees
uI-l
Unpaid f a m i l y worker
............................................
emp 1oyed
i-lUn
cl
No
i :;:li
................
...................
.................
.................
................
. o . œ
Name
Other s p e c i f y
1I I Y E S
2 [-)oi
memak e r
U
No
Add ress
.................
.................
Name
3 [-)nemployed
.................
oyed and employs o thers
g[-]Self-employed
.. Add...........
ress
................
Other spec i f y
Other s p e c i f y
I
t--
* [ b o m e m a k er
Add ress
and empl oys o t h e r s
w i t h o u t otheremployees
4 I l U n p a i d f a m i l y worker
...............
1................m...........
Other spec¡ f y
21r1Sel f-employed
and employs o t h e r s
Sel f-employed w i t h o u t o t h e r employees
3[-1
4[-jUnpaid
f a m i l y worker
........................................
Other speci f y
1-
i
~ m poyee
l
I
Sel f-employed
]
and amp1o y r o t h e r s
2
3
mSel f-employed w i thout o t h e r employees
4 r I U n p a i d f r n i l y worker
......................~..*..
....................
i1
)
Other specify
Other spec i f y
t n p l oyee
[-]Homemaker
2
15
1
31
6
1
2 1 1 S e l f-employed and employe o t h e r s
nNo
.................
emp 1oyed
[-]Un
Other speci fy
114c
2 I-IMomemaker
a u n e m p l oyed
.................
Other spec i f y
1-
.................
.................
Neme
2 1 1 5 0
YES
i
.................
Address
................
homemak maker
2
3 L-lUnenpl
Address
I...............
311
-
Self-employed w i t h o u t o t h e r employees
4[-jUnpaid
f a m i l y worker
.......................................a'....
Other s p e c i f y
1-1 h p l oyee
2I
Sel f-empl
]
oyed and empl oys o t h e r s
i
3[-1Sel
f-employed
4
unpaid f a m i l y worker
........................................
Other s p e c i f y
.-
Gnployee
.................
Sel f-empl oyed and empl oys o t h e r s
Name
oyed
31
J s e l f-employed w i t h o u t o t h e r employees
4I-lUnpaid
.................
................
'
.................
.................
.................
Other speci f y
YES
]-[i
2n
5n
U
3
6
[-]Homemaker
3 1 \ U n e m p l oyed
.................
G
Other speci f y
r
2
i 5
1
3
06
1
3
O
N
O
1
Name
Add r e s
.................
IUnemployed
.................
Other spec i
fy
Mame
.................
................
Ad ress
w i t h o u t o t h e r employees
f a m i l y worker
............................................
Other s p e c i f y
~
~
~
~
~and employs
~
l o toh e r s y
e
d
o
y
.
1
31
]Self-employed
a I-)Jnpaid
-
w i t h o u t o t h e r employees
fami l y worker
............................................
~
3/-]Sel
~
Other s p e c i f y
~
~
~and employs
~
~ o t h~e r s l
f-employed w i t h o u t o t h e r employees
4 / ] u n p a i d fami l y y r k e r
............................................
Other spec i fy