Questionnaire Text

Questionnaire form view entire document:  text  image

Only for people 10 years and older
[Applies to questions O - U]


R. If have children, how many, including those that were born dead?

____ children
00 don't have

Questionnaire instructions view entire document:  text  image

The following questions are shown only on questionnaire C.d. 2. The questions will be asked only to persons age 10 or over


Question R - If had children, how many, including stillborn?

The person's response (including both men and women) should include all children born alive or stillborn, of the current and of previous spouses; illegitimate children must be included in the response.
Fetuses of less than 7 months should not be considered stillborn.
For those who have never had children, an X should be marked in the box entitled does not have.