182060-1931-Supplementary-Draft-Census-Order — Page 3

Industry, Trade or Service with which connected.

Relationship to Head of

Household.

MARRIAGE.

AGE AND

SEX.

BIRTHPLACE AND NATIONALITY.

Length of

RACE.

residence int DEGREE OF EDUCATION. Hong Kong,

PROFESSION OR OCCUPATION.

31

of

State here the pre- cise branch Profession, Trade, Manufacture, Ser-

vice, &c.

-ednost i ovom

ΙΟ

tion is connected with Trade Manufacture, the reply should be sufficient to show

the

kind

particular

Work

of

done, the Material worked in, and the Article made or dealt in, if any.

State the industry, trade or service in

which engaged. This question can

-Su_eq K[[PIGIOG

wered by stating the business car- ried on by the employer. (No en- try to be made here for domestic servants in private employment).

Read

and

write

Speak

English.

English.

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 household or establish- ment :--

(1) passes that night in the dwelling

of the household

or establishment,

or

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

on

the morning of Sunday, 8th March not hav- 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.

ǝy

(last Birthday).

(1) If born in

the United

Kingdom write

jo de I

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 Sea

19

(D) State

whether of

British

parentage.

(2) Naturalised British subject,

or

(3) If of foreign nationality, state whether U. S. Citizen,

Dutch, Japanese, &c.

State whether of English,

Chinese,

Portuguese, Sikh, Filipino, Parɛce, Tamil, Jew, etc. f of mixed race state dominant race, or write Eurasian, etc.

If not boru

in Colony

state period

Jo

years

resident.

If less than

ava ano

write a cross

(X).

State

whether able to read and write Mother

Tongue:

if not,

what other

language.

(D)

1

(4)

(2)

(3)

Males. Females.

(5)

(6)

(7)

(OD

(6)

(9)

(12)

(13)

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

Address

(Head of Household).

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