NAME

AND SURNAME.

Relationship to Head of Household,

160

Appendix A.—Continued.

Form shewing particulars to be stated in the return.

MARRIAGE.

AGE AND SEX.

BIRTHPLACE AND NATIONALITY.

RACE.

Length of residence in Hong Kon.

DEGREE OF EDUCATION.

PROFESSION OR OCCUPATION,

Of every person who is alive at midnight on the night of Saturday, 7th March, 1931, and who. whether as member of the family or as visitor,! boarder or servant in the Lousehold or establish- ment:--

(1) passes that night in the dwelling

of the household or establishment,

OF

(2) arrives and is re- ceived into the household or es- tablishment

on

the morning of Sunday,

8th

March not bay.

ing already been enumerated else- where.

State whether Head or Wife, Mother, Son, Daughter, Step-son, or other Relative,

Visitor, Boarder, or Servant.

State whether Single, Married, Widowed, or Divorced.

Age

(last Birthday).

(1) If born in the United Kingdom write the name of the County.

(2) If born elsewhere in the British Empire, write

the name of the Country, Province, or State.

(3) If born in a Foreign Country write

the name of the Country.

(4) If born at

Sea write

"at Sca".

(1) State whether of British parentage.

(2) Naturalised British subject,

ΟΓ

(3) If of foreign nationality,

state whether U. S. Citizen, Dutch, Japanese, &c.

State whether of English. Chinese, Portuguese, Sikh, Filipino, Parsce, Tamil, Jew, etc.

If of mixed race state dominant race, or write Eurasian, etc.

If not born

in Colony state period of years resident.

It less than one year write a cross (x).

State

whether able to read and

write Mother Tongue; if not, what other language.

(1)

(2)

(8)

(4)

¡ Males.

Females.

(5)

State whether able to

Personal Occupation.

Read and write

English.

Industry, Trade or Service with which connected.

Speak English.

01

State here the pre- cise branch of Profession, Trade. Manulacture, Ser- vice, &c.

Where the occupa- tion is connected with Trade Manufacture, the reply should b sufficient to show the particular kind of Work done, the Material worked in, and the Article made or dealt in, if any,

State the industry trade or service 1 which engagi

This question e generally be 10: wered by statu the business c ried on by employer. (ver try to be mad here for domestic servantsin private employment).

(6)

(7)

(8)

(9)

(10)

(11)

(12)

(13)

1 declare that this Form is correctly filled up to the best of my knowledge and belief.

Signature.....

(Head of Household).

Address

(In respect of which the above particulars are given).

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