Population Census Questionnaire (5-6 Dec., 2005) Type of Household or Public House 1-National 5- Internal Residence 2-Non-national 6- Hospital 3- Collective 7- Others 4- Worker’s Gathering Personal Computers and Internet No. of Personal Computers in Household Connection to Internet 1- Yes No. of Internet Users in Household 2-No 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Name Father's Name 2 Family Name 1-Male 1-Head of Household 2-Female 2-Husband/Wife 3-Son/Daughter 4-Father/Mother 5-Son, Daughter-in-Law 6-Grandson/Granddaughter 7-Brother/Sister 8-Granfather/Grandmother 9-Other Relationship 10-No Relationship 11- Employee 3 4 5 Without Authorized Documents Nationality Emirate 101 Jordan Sudan Syria Palestine Egypt Iran Pakistan Bangladesh Sri Lanka Philippines India Others ( to be stated) 107 112 113 116 119 206 207 209 217 220 235 6 Previous Nationality 7 For Non Nationals Individual Serial No. of Household Gender Duration of Current Stay in Years Relationship to Head Age on Dec ,5, 2005 Name in Complete Years For All Persons 8 For Persons Aged 10 years or Over Educational Status -Illiterate -Read & Write -Primary -Preparatory -Secondary HighestCertificate Obtained 00 01 02 03 04 9 For Persons Aged 15 Years or Over Individual Serial No. Status 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 1- Never Married 2- Married 3- Divorced 4- Widowed 10 Data on Establishment Where the Individual Works or Worked Relationship to Labor Force 1- Employed 2- Unemployed Ever Worked in UAE 3- Unemployed Never Worked in UAE 4- Housewife 5- Full Time Student 6- Unwilling to Work 7- Unable to Work 8- Over 65 & Not Working 11 (For Unemployed Nationals) Duration of Unemployment in Complete Months Marital 12 Sector 1- Federal Gov. 2- Local Gov. Main Current Occupation (In Details) 3- Combined Name of Main Economic Activity (In Details) Establishment 4-Private Chronic Diseases Type of Disability ( if any) 1- Seeing functions Employment 01- Arthritis Status 1- Employer 2- Own Account 3- Employed 4-Unpaid Worker 5- Foreign 6- Diplomatic Body 7- Without Est. 8-Private Household 9- Others 13 14 15 16 17 02- Asthma 2- Hearing Functions 03- Cancer 04- Diabetes 05- Epilepsy 06- Hypertension 07- Cholesterol 08- Angina pectoris 09- Heart failure 10- Renal failure 11- Migraine 12- Sickle-cell disorder 13- Intracerebral hemorrhage 14- Thalassaemia 3- Voice Functions 4- Mobility and movement functions 5- Walking and moving 6- Carrying, moving and handling objects 7- Learning and applying knowledge 8- Self-care 9- Other functions 18 19 Introductory Data on Household or Public House Name of Hamlet: Building Coordinate Number: Serial No. of Census Entrance No. of Households in Unit No. of Hamlet: Name of Building Owner: Serial No. of Unit in Census Entrance Serial No. of Household in Unit Building Census Number : Number of Census Entrances Type of Unit Name of Public House Building Arrangement Number: Location of Unit in The Entrance: ................ : ﺭﻗﻡ ﺍﻷﺴﺭﺓ ﺒﺎﻝﺴﺠل Population Census Questionnaire (5-6 Dec., 2005) ( 3 ) Page No.: Page Summary No. of Individuals Nationals Male Female Non-nationals Male Female Labor Force Total Nationals Non-nationals Employed Unemployed Employed Unemployed Total س
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