Enumeration Block Code

Government of Pakistan
Ministry of Planning, Development & Special Initiatives
Pakistan Bureau of Statistics

QUESTIONNAIRE
OF
PAKISTAN DEMOGRAPHIC SURVEY
2020

PROVINCE/REGION URBAN/RURAL PRIMARY SAMPLING UNIT HOUSEHOLD

Name of Head of Household Address _______________________________________

 SURVEY INFORMATION

Enumeration Block Code Processing Code

ENUMERATION 11. Remarks of Chief SO/ Supervisor/ Enumerator (If any):-

1. INTERVIEWER NAME ...…………..…........…………… CODE

d d m m y y ……………………………………………………………………………………
2. DATE OF ENUMERATION
……………………………………………………………………………………
3. NAME OF RESPONDENT ....................................................

4. BEHAVIOUR OF THE RESPONDENT ……………………………………………………………………………………

1=Co-operative 2= Normal 3= Reluctant/ Hesitant 4= Non serious/ Talkative

……………………………………………………………………………………
5. STATUS OF INTERVIEW

1=Completed 2= Partially Refused 3= Refused 4= Non-Contact ……………………………………………………………………………………

6. Respondent's Relation to Head of Household

01= Head, 02= Spouse, 03= Son/Daughter, 04= Grandchild, 05= Father/Mother, 06= Brother/Sister, ……………………………………………………………………………………
07= Nephew/Niece, 08= Son/Daughter-in-law, 09= Brother/Sister-in-law, 10= Father/Mother-in-law,
11=Grand Father / Mother, 12= Real Uncle/Aunt, 13=Servant/their relatives, 14= Other
……………………………………………………………………………………
7. LANGUAGE OF INTERVIEW

01=Urdu 02=Punjabi 03=Sindhi 04=Pashtu 05=Balochi 06=Kashmiri 07= Balti ……………………………………………………………………………………

08=Hindko 09= Saraeki 10=Brahivi 11= Other

8. TYPE OF FAMILY ……………………………………………………………………………………

1=Nuclear 2= Joint /Extended 3=Other

VERIFICATION
9. SUPERVISOR.…………..…........…………… CODE DATE OF SUPERVISION
( Name ) d d m m y y

SIGNATURE…………………………………

EDITING OF QUESTIONNAIRE AT H/Q

10. EDITOR.…………..…........…………… CODE DATE d d m m y y SIGNATURE OF SUPERVISOR ………………..
(Name)
SECTION- 1: HOUSEHOLD ROSTER

ID 1.Name of household 2.Relation to 3.Sex 4.Residential 5. Age (Day, Month, Year 6.Marital 7.ID 8.ID 9.ID 10.Is Literacy Formal Education
Code members who “usually head of Status which is unknown, try to probe Status Code of Code of Code of ......a (10 years and above) (4 years and above)
live and eat here” Do not household with the help of event calendar, spouse Father Mother usual 11. Can ... Read 12. Can ... 13. Attended 14. Education
list guests, visitors etc. 01= Head 1=Male 1=Present whichever is not known write 1= Never Married ( Write 99 ( Write 99 ( Write 99 member simple Write simple any educational level completed
02= Spouse 2=Currently If not a If not a If not a
03= Son/Daughter 2= 2=Temporari 00 in the col. of day, month, Married member of member of member of of the statement in any statement in any Institute?
1=less than primary.
04= Grand child Female ly Absent year). 3=Widow/Widow household)
household household
househo language with language with 1=Yes 2=Primary
05= Father/Mother Note: Write year in 4 digits & er ld? full full 2=No → Next
and 98 if and 98 if 3=Middle
06= Brother/Sister 4=Divorced
07= Nephew/Niece write 99 for age 100 years or 5= Separated not alive) not alive) 1=Yes understanding? understanding? Section 4=Matric
5= Intermediate
08=Son/Daughter-in- greater 6=Nikkah 2=No 1=Yes 1=Yes 6=
law Age in solemnized but 2=No→ Q 12 2=No Graduate/Equivalent
09= Brother/Sister-in- Rukhsati not
complete Date of Birth 7=Higher Education
law
taken place 8=
10= Father/Mother-in- Years Diploma/certificate
law Year Month Day 9= Other (specify)
11=Grand
Father/Mother
12=Real Uncle/Aunt (If code 1,3,4,5,6
13=Servants//their → Q8)
relatives
14= Other

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

1
 SECTION- 2: FERTILITY
(All Ever Married Women Aged 15-49 years)

ID CODE 1.Age at 2.Duration since first 3. Have you ever 4.Age at 5.When first 6. How many children 7.Of these children how many are 8. Have you ever 9. How many died? 10.Have you
from roster first Marriage given live birth? the time of child born ever born alive presently living given birth to any ever had a still
for all ever Marriage first birth after first (if none write “00”) child who born birth
married (In complete 1=Yes marriage ( if none write “00”) alive but later
years) (In complete
women With You Else Where died, even if they 1=Yes
years)
aged 15-49 2=No → Q 10 lived for few
year minutes or hours? 2=No
(In complete
months)
1=Yes
Year Month B G T B G B G B G
2=No→ Q10

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Live Birth:- A birth is counted as a live birth if the baby breathed or showed any sign of life ,even if he/she live only a few minutes.
SECTION- 3: BIRTH ENUMERATION FORM
Particulars of Child Born during Last Three Years (1st January 2018 to 31st December 2020) If No then skip this section

1. Sr. No 2. Is Mother 3.ID 4. Baby’s Name 5. Sex 6.Date of Birth 7.Nature 8.If 9. Place of 10. Person 11. Is this 12.ID 13. How long the 14. Interval
of babies usual Code of 1=Male of Birth multiple Birth assisted in Child still Code of child lived between this
2=Female
born member of Mother 1=Single→Q 1=Boys 1=Home delivery Alive this and previous
during this from 9 2=Girls 2=Govt. baby birth
2=Multiple Hospital/facility 1=Doctor 1= Yes
last three Household roster
3=Both → Q14 98=First birth
years. 3= Private 2=LHV 2= No → Q13
1=Yes, Hospital/facility & ( also fill 99=Don’t know
4=Other Death
3=Nurse
2=No→Q4 Year Month Day Enumeration
Form )
4=Midwife

Year Month Day Year Month

5= Trained
Dai//Traditional
birth attendant

6=LHW

7=Family Member/
Relative / Neighbor

8=Other(Plz
Specify)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
SECTION- 4: DEATH ENUMERATION
Q1. Any death occurred during last three years (1st January 2018 to 31st December 2020) 1=Yes (fill Q2 and give details of each death.), 2=No (End of interview).

2.Sr. 3.Name of 4.Relationship of 5.Sex of 6.Age at death in 7.Nature of 8.Code for cause of Death 9. Place of Death 10. Year of Death
No. Deceased deceased to the deceased completed years Death (consult coding list of causes 1=Home
head of household (mention the of death) 2=Hospital/ Clinic/Dispensary
02= Spouse 1=Male (If less than 1 Cause) 3=On Road
03= Son/Daughter
04= Grand child 2=Female year write 00) 1=Sickness 4=other(specify)
05= Father/Mother 2=Not Clear→Q9
06= Brother/Sister
07= Nephew/Niece
3=Others
08=Son/Daughter-in-law
09= Brother/Sister-in-law
10= Father/Mother-in-law
11=Grand Father/Mother
12=Real Uncle/Aunt
13=Servants//their relatives
14= Other

1 2 3 4 5 6 7 8 9
Codes for causes of death
List of Diseases Codes
1. Measles 01
2. Chicken Pox 02
3. Tuberculosis 03
4. Rabies 04
5. HIV Aids 05
6. Malaria 06
7. Gastroenteritis with severe Diarrhea and Vomiting 07
8. Dengue 08
9. Viral Hepatitis 09
10. Jaundice 10
11. Fever 11
12. Cancers 12
13. Leukemia 13
14. Anemia 14
15. Paralysis (stroke) 15
16. Diabetes 16
17. Cardiovascular disease 17
18. Hypertensive diseases 18
19. Respiratory diseases 19
20. Asthma 20
21. Piles 21
22. Ulcer 22
23. Hernia 23
24. Appendicitis 24
25. Liver diseases 25
26. Diseases of Gallbladder 26
27. Disorders of kidneys 27
28. Diseases of intestine 28
29. Complications During Pregnancy 29
30. Complications during Delivery 30
31. Post-Natal Complications 31
32. COVID-19 32
33. Other diseases (Specify) 33
Other Reasons of death
34. Injuries 34
35. Poisoning (by drug, biological & other solid & liquid substances) 35
36. Burns 36
37. Suicide 37
38. Snake Bite 38
39. Murder (Homicide) 39
40. Traffic Accident 40
41. Accidental Falls/ Drowning 41
42. Sun Stroke 42
43. Surgical Complications 43
44. Death Penality 44
45. Martyred 45
46. Death in Bomb Blast 46
47. Other (Specify) 47