Literal question
If institution, write name ________
<br />County _ _
<br />District _ _
<br />Township / Clan _ _</p>
<div class="i1">Structure No. _ _ _</div><p>EA _ _ _</p>
<div class="i1">Household No. _ _ _</div><p>Locality _ _ _</p>
<div class="i1">Population type _ _ _</div><p>Locality name ________
<br />Street address ________