Basic HTML Version
ASK ONLY OF THE HEAD OF HOUSEHOLD OR ANY OTHER RESPONSIBLE ADULT
Please give me the names of all persons who are usual residents of this household. By that I mean the persons who
reside here all or most of the time even if they are temporarily away. Please remember to include yourself. Please give
me the name of the head of the household first.
Person 1
Person 2
Person 3
Person 5
Person 6
Person 7
Person 8
Person 9
Person 10
FIRST NAME
LAST NAME
FIRST NAME
FIRST NAME
FIRST NAME
FIRST NAME
FIRST NAME
FIRST NAME
FIRST NAME
FIRST NAME
Person 4
FIRST NAME
LAST NAME
LAST NAME
LAST NAME
LAST NAME
LAST NAME
LAST NAME
LAST NAME
LAST NAME
LAST NAME
Number of Persons Enumerated
Male
Female
18 Years & Over
PC 011A
SECTION 4
4.2 Please give me the number of persons from this
household who went to live abroad permanently since
January 1, 2010 and the sex and age of each.
Number of Persons
Person
Number
Sex
M F
Not Stated
Age
1
2
3
If Age Not Stated Record '9's
4
4.1 Did any one from this household go to live abroad
since January 1, 2010?
Yes
No
Not Stated
SECTION 4
1 0 0 0 0 0 0 1
STATISTICAL INSTITUTE OF JAMAICA
(Go to Q4.3)
5
6
7
8
(For all persons)
IDENTIFICATION
SECTION 1
4.4 Please give me the number of persons from this
household who have died since January 1, 2010 and
the sex, age and date of death of each.
Total
Male
Female
Per
son
No.
1
2
3
4
Sex Date of Death
Month Year
Age at
death
Cause
of death
(Code)
If Date of Death, Age of
Death, and Cause of Death
Not Stated Record '9's
N\S FM
MIGRATION & MORTALITY
Codes:
1 - Violence
2 - Accident
3 - Suicide
4 - Natural Causes
5 - Other
4.3 Has any member of this household died since
January 1, 2010?
Yes
No
Not Stated
(End Interview)
N\S = Not Stated
PC 011A
Confidential
PARISH CONSTITUENCY ENUM DIST.
HOUSING UNIT DWELLING HOUSEHOLD
POPULATION AND HOUSING CENSUS - 2011
57237