Attachment 9

SUSENAS VSEN93.LPK
REPUBLIC OF INDONESIA
CENTRAL BUREAU OF STATISTICS
1993 NATIONAL SOCIO ECONOMIC SURVEY
CONSUMPTION OF PREPARED FOOD/BEVERAGES
(CONSUMPTION OF NON COOKING FOOD/BEVERAGES/
PREPARING BY HOUSEHOLD)
Confidential
I. LOCATION IDENTIFICATION
01 Province
02 District/Municipality *)
03 Sub-District
04 Village/Village Unit *)
05 Area Urban 1 Rural 2
06 Enumeration area number
07 Segment group number
08 Packet number
09 Susenas Sample code number
10 Sample household serial number
11 Number of Household members
12 Name of Household head
II. ENUMERATION PARTICULARS
01 Name and NIP/NMS of
Enumerator:
04 Name and NIP/
NMS of supervisor
02 Date of Enumeration 05 Date of supervision:
03 Signature 06 Signature
*) Cross out inapplicable category
III. CONSUMPTION OF PREPARED FOOD/BEVERAGES BY THE HOUSEHOLD
DURING PREVIOUS WEEK DATED .1993 TO ..1993
Day/Date Type of prepared
food/beverages
Quantity Value (Rp) Food origin
(1) (2) (3) (4) (5)
IV. PREPARED FOOD/BEVERAGES CONSUMED OUTSIDE THE HOUSEHOLD
DURING THE PREVIOUS WEEK DATES.1993 TO .1993
Name of
household
members
Day/Date Type of
prepared
food/beverages
Quantity Value (Rp) Food Origin
(1) (2) (3) (4) (5) (6)