MARRIAGE REGISTRATION FORM
1. BACKGROUND
1.0 START TIME
1.1 FIELD WORKER’S CODE
1. 2. DATE OF INTERVIEW
1.3. INDIVIDUAL’S NAME…………………………………………..……………… ……………………………………………
1.4. INDIVIDUAL’S ID
1.5 ID FOR ROOM WHERE PERSON SLEEPS
1.6 DATE OF BIRTH
1.7 RESULT OF INTERVIEW 1=completed; 2=no competent respondent at home; 3=Entire household absent
for extended period; 4=refused; 8=other (specify)
2. DETAILS OF CURRENT MARITAL STATUS
2.1.CURRENT MARITAL STATUS: M=Married; L=Living Together (cohabiting) W=Widowed; D=Divorced;
S=Separated; N=Never Married K=Not known. O=Other (specify)……………………………………………
2.2. NUMBER OF TIMES PERSON HAS BEEN MARRIED TO OR COHABITED WITH IN LIFETIME
(98=DK; 97=Refusal; 00=Never married/Never cohabited) If “N” IN 2.1 ANSWER 2.2 AND Q6.1
2.3. NUMBER OF TIMES PERSON HAS BEEN MARRIED (98=DK; 97=Refusal)
If “W” “D” & “S” IN 2.1 ANSWER 2.3 AND Q6.1
2.4. NUMBER OF CURRENT SPOUSES (FOR MEN) OR NUMBER OF CO-WIVES (WOMEN) ,
INCLUDING COHABITATION PARTNERS (8=Don’t Know) If ANSWER IS “8” Q6.1
3. INFORMATION ABOUT CURRENT SPOUSE
st
3.1. NAME OF CURRENT SPOUSE (or 1 WIFE FOR MEN)…..………………………………………………….……..
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3.2 NAME AND CODE FOR PLACE WHERE SPOUSE USUALLY LIVES (Get code from )
(P)….……………………(D)………………………….(L).…..……………………(V/E)….…………………………
3.3 ID FOR SPOUSE
3.4 DATE WHEN MARRIED THIS SPOUSE ________(name)
4. INFORMATION ABOUT SECOND WIFE IF MAN HAS 2 OR MORE WIVES
4.1. NAME OF SPOUSE
…………………………………………………………………………………………………………….
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4.2 NAME AND CODE FOR PLACE WHERE SPOUSE USUALLY LIVES (Get code from )
(P)….……………………(D)………………………….(L).…..……………………(V/E)….…………………………
4.3 ID FOR SPOUSE
4.4 DATE WHEN MARRIED THIS SPOUSE _________(name)
5. INFORMATION ABOUT THIRD WIFE IF MAN HAS 3 OR MORE WIVES
5.1. NAME OF SPOUSE ……………………………………………………………………………………………
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5.2 NAME AND CODE FOR PLACE WHERE SPOUSE USUALLY LIVES (Get code from )
(P)….……………………(D)………………………….(L).…..……………………(V/E)….…………………………
5.3 ID FOR SPOUSE
5.4 DATE WHEN MARRIED THIS SPOUSE
______________(name)
6. RESPONDENT’S PARTICULARS
6.1 RESPONDENT’S NAME ………………………………………………………………………………………………….
6.2 RESPONDENT’S ID
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6.3 RESPONDENT’S RELATIONSHIP TO PERSON (Get code from ) (OTH……………………….)
6.4 END TIME
7. OFFICE/FIELD CHECK DETAILS
7.1 FS CODE & CHECK DATE
7.2 OFFICE CODE & CHECK DATE
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Where spouse lives: Code: 1=In the same household; 2=In the another household within the DSA; 3=In Another Slum in Nairobi,
4=In non-slum parts of Nairobi; 5=In an urban area of Kenya other than Nairobi; 6=Rural Kenya; 7=Outside Kenya, 8=Don’t Know;
9=Outside the DSA but within the DSA slum.
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Relationships: AUN= Aunt; BIL=Brother-in-law; BRO= Brother; CHD = Child; COU=Cousin; CWF = Co-wife; DIL = Daughter-in-
law; GCH = Grand child; GDP = Grand parent; HHH=Household head; HUS = Husband; NEP= Nephew; NIE=Niece; NRL = Not
related; PAR = Parent; PIL = Parent-in-Law; SIL=Sister-in-law; SIS=Sister; SLF =Self; SOL= Son-in-law; STP=Step child; STA=Step
parent; UNC=Uncle; UNK = Unknown relation; WIF = Wife SLF=Self; OTH = Other (specify______)
