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SUSENAS CONFIDENTIAL SUSENAS V.1 82 CONSUMPTION CENTRAL BUREAU OF STATISTIC 1982 NATIONAL SOCIO-ECONOMIC SURVEY LISTING V.1: FOOD/BEVERAGES CONSUMPTION REGULAR/PARTICULAR HOUSEHOLD (Daily Records) I. LOCATION IDENTIFICATION 1. Province 2. Dictrict/Municipality *) 3. Urban/Rural area *) 4. Susenas Sample Code Number 5. Household Serial Number 6. Name of Household head 7. Number of household members 8. Name of particular household **) 9. Head/Leader s name 10. Number of inhabitants 11. Address II. ENUMERATION PARTICULARS 1. Name of enumerator 2. Date of enumeration 3. Enumerator s signature *) cross out either one **) Detail 8 to 11 fill in only for particular household 2
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INFORMATION HOW TO FILL THE DAILY RECORD What is recorded in this Daily Record are all foods/beverages that are consumed by all household members, every day during one week. This could be food/beverage that is either prepared by the household or those that have been bought or received from others. This Dairy Record consist of 3 (three) parts: Part A Part B : List household members names including their characteristics. Particular households are represented by only 10 people. : Note all cooked foods/beverages prepared by the household and consumed by household members, excluding those that are sold, given to others or that used as animal feed. Food/beverages could be have be bought, own production, given from other party, etc. Part of C1/C2 : Note prepared food/beverage, i.e. cooked food/beverage/ prepared by other party and consumed directly. These prepared food/beverage could be those that have been bought or given or shared. Prepared foods/beverages are divided into: C1 C2 : food eaten in the house/the yard such as: buying gado-gado (vegetables with peanut sauce) from a food stall and bringing it to eat at home; buying bakso/meatball soup from a vendor passing in front the house;fried bananas given by the nieghbour, etc. : food eaten outside the house, such as: buying snack at school, food eaten at the food stall, eating/drinking during a trip, eating during a meeting, eating at aparty, etc. Unit, e.g.: plate, bowl, unit, package, pieces, slices, kg., etc. Column (6) to (11) fill in with a check sign (!). Could be more than one check /! sign. For foods that are own production or given, and prepared food/beverage that were given, please estimate their appropriate value as per local price (at the closest market) 4
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Serial number A. NAMES OF HOUSEHOLD MEMBERS Please write down the names of all household members who live in this household: Name of Household member Relationship to Head of Household Age Gender F/M Daily activity Do you usually consume prepared food/beverage? Yes/No (1) (2) (3) (4) (5) (6) (7) Relationship to the head of household: Day by day activity: - Household head - Work/temporarily not working - Husband/Wife - Looking for a job - Children - Attending school - Son/daughter in Law - Taking care of household - Grandchildren - Retired, disabled, etc - Parents/Parent in law - Other relatives - Servant - Other 6
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B. CONSUMPTION OF COOKED FOOD/BEVERAGE PREPARED BY HOUSEHOLD Type of food/beverage Local unit Day 1: Day 2: Day 3: Conversion from one local unit to Kg.* Quantity in local unit Value (Rp) Quantity in local unit Value (Rp) Quantity in local unit Value (Rp) (1) (2) (3) (4) (5) (6) (7)) (8) (9) a. Cereals 1. Rice 2. Glutinous rice 3. Wet corn with skin 4. Dry corn with skin 5. Dry shelled corn 6. Corn flour 7. Wheat flour 8. Other x x x x X b. Tuber 1. Cassava 2. Dried cassava 3. Tapioca 4. Dried cassava flour 5. Sweet potato 6. Other (potato, taro, sago, etc) x x x X X c. Fish: fresh water fish, salted /dried fish, canned X X X fish, shrimp, squid, crab, etc. d. Meat: beef, buffalo, goat, pork, chicken, X X X incl. bones, innards, dried meat, dried shredded meat (abon), canned corned beef. e. Egg and Milk: chicken egg, duck egg, salted egg, and pure milk, factory-processed liquid milk, cheese, etc X X X f. Vegetable: spinach, water spinach, cabbage, X X X string bean, tomato, eggplant, chili, onion, etc. g. Pulses: peanut, mungbean, kidney bean, X X X soybean, tofu, tempe, fermented soybean sauce, oncom, etc h. Fruits: Orange, mango, apple, rambutan, X X X lanzon, durian, snake fruit, pineapple, banana, sawo, jackfruit, etc i. Others: salt, spices, soy sauce, fish paste, X X X coconut, frying oil, butter, palm sugar, granulated sugar, tea, coffee, shrimp/fish crackers, emping, rice noodle, etc j. Tobacco, betel: cigarette, clove cigarette, X X X tobacco, betel, areca nut, etc Total x X X Number of people eating persons persons pers 8
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B. CONSUMPTION OF COOKED FOOD/BEVERAGES PREPARED BY HOUSEHOLD Day 4: Day 5: Day 6: Day 7: Total Quantity in local unit Value (Rp) Quantity in local unit Value (Rp) Quantity in local unit Value (Rp) Quantity in local unit Value (Rp) Quantity Local Kg *) Unit Value (Rp) (10) (11) (12) (13) (14) (15) (16) (17)) (18) (19) (20) persons persons persons persons *) fill in by enumerator 10
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Day/ date C1. PREPARED FOOD/BEVERAGES CONSUMED IN THE HOUSE a. Please write down all the types of prepared food/beverages (food/beverage that are not cooked/prepared by the household) consumed by household members b. Please write down the quantity and the value, and whether they were bought or given Type of prepared food/ beverages Quantity Unit Value This food is made of: (Rp) Rice Corn Cassava Sweet Wheat potato flour Other Food origin (1) (2) (3) (4) (5) (6) (7)) (8) (9) (10) (11) (12) Day 1. Day 2. Day 3. 12
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Day/ date Type of prepared food/ beverages Quantity Unit Value This food is made of: (Rp) Rice Corn Cassava Sweet Wheat potato flour Other Food origin (1) (2) (3) (4) (5) (6) (7)) (8) (9) (10) (11) (12) Day 4. Day 5. Day 6. Day 7. 14
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Day/ date Name of household member: C2. PREPARD FOOD/BEVERAGES CONSUMED OUTSIDE THE HOME a. Please write down all the types of prepared food/beverages consumed by the household member whose name is written above (as per col. (2) Part A) b. Please write down its quantity and value, e.g. snacks bought at school/office/food stall/market, during a trip (train, boat, airplane, hotel/inn) and food eaten at the party. Type of prepared food/ beverages Quantity Unit Value This food is made of: (Rp) Rice Corn Cassava Sweet Wheat potato flour Other Food origin (1) (2) (3) (4) (5) (6) (7)) (8) (9) (10) (11) (12) Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 16