THE REPUBLIC OF THE Questionnaire number of for this household

UNION OF MYANMAR Township/

HOUSEHOLD IDENTIFICATION
Ward/Village Urban or Enumeration Area
MINISTRY OF IMMIGRATION AND POPULATION State/Region District SubTownship Tract Rural (Block No.) Household No.

22014 POPULATION AND HOUSING CENSUS

Main Questionnaire 0 0 0 0 0 0 0 0 0 Urban 0 0 0 0 0 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
INSTRUCTIONS FOR COMPLETION 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

USE 2B BLACK PENCIL ONLY. Write then shade like this: 3 3 3 3 3 3 3 3 3 Rural 3 3 3 3 3 3
4 4 4 4 4 4 4 4 4 2 4 4 4 4 4 4

or this: 1 2 3 4 5 6 7 8 9 10 0 0 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
1 1 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6

Write numbers like this: 2 2 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7

3 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8
9 9 9 9 9 9 9 9 9 9 9 9 9 9 9

FOR ALL MEMBERS OF THE HOUSEHOLD

1. 2. Name 3. Relationship to the head of the 4. Sex 5. Completed Age 6. Marital status 7. Religion 8. Ethnicity DISABILITY
(Write all persons who spent the night of 29 household If age greater than or 9. Does (Name) have any difficulty...?
March 2014 in this household. Make sure to
Grandchild/Great grandchild
equal to 98, write i. Seeing, even if wearing glasses Codes
include babies, elderly persons, disabled “98”. If less than one
household member

No - no difficulty = 1

Single (Never married)

ii. Hearing, even if using hearing aid
Parent/Parent-in-Law
Son/Daughter-in-law

persons and visitors)

Divorced/Separated
write “00”. Yes - some difficulty = 2
Serial number of

Head of Household

iii. Walking, climbing steps, carrying items

iv. Remembering or concentrating Yes a lot of difficulty = 3
ONLY PERSONS WHO SPENT THE Other Relative Cannot do at all = 4

Other Religion
Adopted Child
Son/Daughter

Non Relative
Grandparent

CENSUS NIGHT IN THIS HOUSEHOLD Seeing Hearing Remembering

No Religion
Renounced
Walking

Widowed

Christian
Buddhist
Female
Spouse

Married

Animist
Sibling

Hindu
Islam
Male
In Years

1 1 2 3 4 5 6 7 8 9 10 11 1 2 1 2 3 4 5 1 2 3 4 5 6 7

2 1 2 3 4 5 6 7 8 9 10 11 1 2 1 2 3 4 5 1 2 3 4 5 6 7

3 1 2 3 4 5 6 7 8 9 10 11 1 2 1 2 3 4 5 1 2 3 4 5 6 7

4 1 2 3 4 5 6 7 8 9 10 11 1 2 1 2 3 4 5 1 2 3 4 5 6 7
© DRS Data Services Limited [2013]/O03120813/ASDZ

5 1 2 3 4 5 6 7 8 9 10 11 1 2 1 2 3 4 5 1 2 3 4 5 6 7

6 1 2 3 4 5 6 7 8 9 10 11 1 2 1 2 3 4 5 1 2 3 4 5 6 7

7 1 2 3 4 5 6 7 8 9 10 11 1 2 1 2 3 4 5 1 2 3 4 5 6 7

8 1 2 3 4 5 6 7 8 9 10 11 1 2 1 2 3 4 5 1 2 3 4 5 6 7

CONFIDENTIALITY:
We assure that the personal information collected in this interview is confidential and will not be
disclosed in any way. 12345678(90)
© DRS Data Services Limited [2013]/O03130813/IFQO

12345678(90)

FOR ALL MEMBERS OF THE HOUSEHOLD AGE 5 AND ABOVE AGE 10 AND ABOVE
IDENTITY CARD MIGRATION EDUCATION LABOUR FORCE
10. Type of identity card Place of Birth Place of Usual Residence 15. Duration in 16. Reason for Place of Previous Usual 19. Can 20. Is (Name) 21. What is the highest Activity Status
place of usual movement to this Residence (Name) read currently education grade/level (Name) 22. What was (Name’s) activity
11. Township 12. 13. Township 14.
residence (in township (usual and write in attending,previ completed? status during the last 12 months?
If born here write “000”, Urban If here write “000”, if not Urban
years) residence) 17. Township 18 . any ously attended
if not write Township or write Township code or Urban language? (April 2013 - March 2014)
Rural If less than 1 If here write “000”, if not or never
Naturalised Scrutiny Citizenship Card (green)

code Rural or If options 6 to 11 skip to Q25

write Township code attended None - 00
National Registration Card (three fold card,

year write “00”

Associate Scrutiny Citizenship Card (blue)

Rural school/ Grade - 01-11

Employment/in search for employment

college?
Temporary Registration Card (white)

College - 12
Foreign Registration Card (FRC)

Pensioner, retired, elderly person

green for men, pink for women)

Vocational training - 13
Citizenship Scrutiny Card (pink)

None of the documents above

Undergraduate diploma - 14

Contributing family worker

Graduate - 15

Employee (Government)
Employee (Private, Org)
Child below 10 years

Postgraduate diploma - 16

Own account worker

Previously attended
Currently attending

Did not seek work

Foreign Passport

Masters Degree - 17

Full time student

Household work
Followed family

Never attended
Serial Number

Religious Card

PhD - 18

Did not move

Sought work

Ill, disabled
Education
Other - 19

Employer
Marriage

Conflict
Urban

Urban

Urban
Other

Other
Rural

Rural

Rural

Yes
No
Enter code from manual Enter code from manual Enter code from manual

1 1 2 3 4 5 6 7 8 9 10 1 2 1 2 1 2 3 4 5 6 7 1 2 1 2 1 2 3 1 2 3 4 5 6 7 8 9 10 11 12

2 1 2 3 4 5 6 7 8 9 10 1 2 1 2 1 2 3 4 5 6 7 1 2 1 2 1 2 3 1 2 3 4 5 6 7 8 9 10 11 12

3 1 2 3 4 5 6 7 8 9 10 1 2 1 2 1 2 3 4 5 6 7 1 2 1 2 1 2 3 1 2 3 4 5 6 7 8 9 10 11 12

4 1 2 3 4 5 6 7 8 9 10 1 2 1 2 1 2 3 4 5 6 7 1 2 1 2 1 2 3 1 2 3 4 5 6 7 8 9 10 11 12

5 1 2 3 4 5 6 7 8 9 10 1 2 1 2 1 2 3 4 5 6 7 1 2 1 2 1 2 3 1 2 3 4 5 6 7 8 9 10 11 12

6 1 2 3 4 5 6 7 8 9 10 1 2 1 2 1 2 3 4 5 6 7 1 2 1 2 1 2 3 1 2 3 4 5 6 7 8 9 10 11 12

7 1 2 3 4 5 6 7 8 9 10 1 2 1 2 1 2 3 4 5 6 7 1 2 1 2 1 2 3 1 2 3 4 5 6 7 8 9 10 11 12

8 1 2 3 4 5 6 7 8 9 10 1 2 1 2 1 2 3 4 5 6 7 1 2 1 2 1 2 3 1 2 3 4 5 6 7 8 9 10 11 12
 AGE 10 AND ABOVE AND EMPLOYED EVER MARRIED WOMEN (AGED 15 AND ABOVE)
LABOUR FORCE Number of children ever born alive Particulars of last live birth
Occupation Industry 25. Number of children ever 26. How many of 27. How many of 28. How many of 29. Date of last live birth 30. Sex 31. Is
born alive those children are those children are those children are of last the
23. What work was (Name) mainly doing during the last 12 24. What is the major product or service provided in the
(If no children, write “00”) living in this living elsewhere no longer alive live child
months? Write detailed work descriptions (for example, organisation/enterprise where (Name) mainly worked during
household? (not in this (dead)? birth still
Primary teacher, Rice farmer, Taxi driver) the last 12 months? Write detailed descriptions (e.g. Hotel
household)? alive?
service, Building construction, Garment manufacture)
Serial Number

Female
Male

Yes
Male Female Male Female Male Female Male Female Month Year

No
1 1 2 1 2

2 1 2 1 2

3 1 2 1 2

4 1 2 1 2

5 1 2 1 2

6 1 2 1 2

7 1 2 1 2

8 1 2 1 2

HOUSING CHARACTERISTICS
32. Type of housing 33. Type of ownership of 34. Main source of 35. Main source of water for drinking and 36. Main type of cooking fuel 37. Type of toilet used 38. Main construction material of the 39. Which of the following items does your household have?
unit occupied by this housing unit lighting in the household non-drinking in this household used in this household in this household housing unit (mark all that apply)
Non-
household Drinking Drinking
Condominium 1 Owner 1 Tap water/Piped 1 1 Yes No Yes No
Renter Roof Wall Floor
Apartment/Flat 2 2 Tube well, borehole 2 2 Flush 1 Radio 1 2
Motorcycle/
Bungalow/ Provided free Electricity 1 Protected well/Spring 3 3 Electricity 1 Dhani/Theke/In leaf 1 1 1 Television 1 2 Moped/
Water Seal
Brick house 3 (individual) 3 Kerosene 2 Unprotected well/Spring 4 4 Liquefied Petroleum Gas (LPG) 2 (Improved PL) 2 Bamboo 2 2 2 Land line phone 1 2 Tuk Tuk 1 2
© DRS Data Services Limited [2013]/O03140813/RLCJ

Semi-pacca house 4 Government Quarter 4 Candle 3 Pool/Pond/Lake 5 5 Kerosene 3 Pit (Traditional pit latrine) 3 Earth 3 3 3 Mobile phone 1 2 Bicycle 1 2
Private Company Quarter 5 Battery 4 River/Stream/Canal 6 6 BioGas 4 Bucket (Surface latrine) 4 Wood 4 4 4 Computer 1 2 4 wheel tractor 1 2
Wooden House 5 Other 6 Generator (Private) 5 Waterfall/Rain water 7 7 Firewood 5 Other 5 Corrugated Sheet 5 5 5 Canoe/Boat 1 2
Bamboo 6 Water mill (Private) 6 Charcoal 6 No toilet 6 Tile/Brick/Concrete 6 6 6 Internet Motor Boat 1 2
Bottled water/water from
Hut 2-3 years 7 vending machine 8 8 Coal 7 Other 7 7 7 at home 1 2
Solar System/
Hut 1 year 8 energy 7 Tanker/Truck 9 9 Straw/Grass 8 Car/Pick-up/ Cart (Bullock) 1 2
Other 9 Other 8 Other 10 10 Other 9 Truck/Van 1 2
© DRS Data Services Limited [2013]/O03150813/YSGH
LIST OF FORMER HOUSEHOLD MEMBERS LIVING ABROAD SUMMARY COUNT
MALE FEMALE TOTAL
40. Number of former household members living abroad

Name of former household member living abroad Relationship to head of household Completed age Sex Year of Departure Country of residence 0 0 0 0 0 0 0
(current) 1 1 1 1 1 1 1
2 2 2 2 2 2 2

Parent/Parent-in-Law
Son/Daughter-in-law
3 3 3 3 3 3 3

Other Relative
Serial number

Adopted Child
4 4 4 4 4 4 4

Son/Daughter

Non Relative
Grandparent
Grandchild

Singapore
5 5 5 5 5 5 5

Malaysia
Thailand
Spouse

Female
Sibling

Japan
Korea
China

Other
6 6 6 6 6 6 6

India
USA
Male
7 7 7 7 7 7 7
1 2 3 4 5 6 7 8 9 10 11 1 2 1 2 3 4 5 6 7 8 9 8 8 8 8 8 8 8
9 9 9 9 9 9 9
2 2 3 4 5 6 7 8 9 10 11 1 2 1 2 3 4 5 6 7 8 9

3 2 3 4 5 6 7 8 9 10 11 1 2 1 2 3 4 5 6 7 8 9
ENUMERATOR
4 2 3 4 5 6 7 8 9 10 11 1 2 1 2 3 4 5 6 7 8 9
Signature

5 2 3 4 5 6 7 8 9 10 11 1 2 1 2 3 4 5 6 7 8 9
Name Date
6 2 3 4 5 6 7 8 9 10 11 1 2 1 2 3 4 5 6 7 8 9

SUPERVISOR
DEATHS IN THE HOUSEHOLD DURING THE LAST 12 MONTHS
Signature
41. Number of deaths in this household in the last 12 months (30-3-2013 to 29-3-2014)
Name Date
Name of the deceased Was the Age at death FEMALES AGED 15-49
deceased
Male or If age is unknown, estimate age using
local historic calendar. Record age in Did the death occur during ...?
Serial number

Female?
completed years. pregnancy? delivery? the first 6 weeks
after delivery?
IF MORE THAN ONE QUESTIONNAIRE IS
Male Yes Yes Yes
1
Female
1
2 No
1
2 No
1
2 No
1
2
USED IN THE HOUSEHOLD, THEN SUMMARY
2 Male 1 Yes 1 Yes 1 Yes 1
Female 2 No 2 No 2 No 2 COUNTS OF ALL MEMBERS MUST BE FILLED
3 Male 1 Yes 1 Yes 1 Yes 1
Female 2 No 2 No 2 No 2 IN ON THE FIRST QUESTIONNAIRE USED
4 Male 1 Yes 1 Yes 1 Yes 1
Female 2 No 2 No 2 No 2