Questionnaire Text

Questionnaire form view entire document:  text  image
4. Please provide the age and the month and year of birth

____ Age
____ Month of birth
____ Year of birth
Questionnaire instructions view entire document:  text  image
Part One. Personal records

All persons should respond to R1 through R7.

R4. Age
Age should be based on Gregorian calendar instead of lunar calendar.
For babies, if younger than ten months (including ten months), age = 2000 - birth year;
If older than ten months (eleven or twelve), age = 2000 - birth year - 1.
[omitted the details of age conversion between lunar and Gregorian calendar.]