Questionnaire Text

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For women 12 years of age and older [Applies to questions 66-72.]

D. Fertility Characteristics

67. What was the date of the birth of your last child born alive, regardless of whether this child is currently alive or dead?

____ Month
____ Year

Questionnaire instructions view entire document: text image

For women 12 years of age and older

Question 67: What is the date of birth of your last child born alive, whether or not the child is currently alive?

The day, month, and year of birth of the last child born alive are recorded and the circles corresponding to the month and year are filled in.