Questionnaire Text

Questionnaire form view entire document: text image

A. General Information

For all individuals regardless of age (including newborn infants)
[Questions 1-8 were asked of all persons.]

5. Where were you born?

If born in this same locality, mark "Here," if born in another place, first write as concretely as possible the locality and then the province and department. If born outside of Bolivia write only the name of the country.

[] Here

____ Other locality
____ Province
____ Department or other country

Questionnaire instructions view entire document: text image

Question 5. Where were you born?

Mark "Here" if a person was born in the locality where they are enumerated.

In the contrary case, write the name of the locality, providence, and department where they were born.

If born abroad, write down only the name of the country.