Questionnaire Text

Questionnaire form view entire document: text image

A. Questions to all persons
[Applies to questions 1-15]

9. Place of birth (persons born in a hospital indicate the parents' or mother's residence at that time):

[] Municipality of current residency
[] Other municipality

____ Indicate which municipality
____ Canton or State (abbreviation)

Questionnaire instructions view entire document: text image

Question 9: Place of birth
If the place of birth was in a foreign country, the name of the current country should be written in.