Questionnaire Text

Questionnaire form view entire document:  text  image

4. How old are you?
Write the age at last birthday. For those under one year write "00".

____ Years completed
Questionnaire instructions view entire document:  text  image

Question 4. How old are you in completed years?

Record on the corresponding line the number of completed years as of the last birthday, and not the number of years that the person is going to complete.

For those less than one year old, record 00.