Questionnaire Text

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E. For women fifteen years old or older.
[Applies to questions 46 - 50]


49. The last child born alive is now :

[] 1 Dead
[] 3 Alive
[] 5 Does not know

Questionnaire instructions view entire document:  text  image

E. Only for women 15 years old or older

(Questions 46 to 50)

Take into account that this part of the form is directed only to women and that it should only be filled out for women who are 15 years old or older, even if they are single.


Question No. 49 The last child born alive is:

[Below the text is a form.]

Mark "x" in box 1, if the last child that was born alive is dead.

Mark "x" in box 3, if the last child born alive is currently alive.

Mark "x" in box 5, if a woman does not know if her last child born alive, is dead or alive.