Questionnaire Text

Questionnaire form view entire document:  text  image
Section F. Characteristics of the persons

For women 12 years old or more
[Questions 18-22 were asked of only females aged 12 years or older]

21. On what date was your last son or daughter born alive?

Day _ _
Month _ _
Year _ _ _ _
Questionnaire instructions view entire document:  text  image
For women 12 years old and older
[Questions 18-22 were asked of women aged 12 years or older]

Question 21: On what date was your last daughter or son born alive?
Write with numbers:

-The day of birth of her last daughter or son born alive.

-The month of birth of her last daughter or son born alive.

-The year of birth of her last daughter or son born alive.

The date should be registered independently of whether the last daughter or son is currently alive or has died. If the last delivery was twins, the date of birth is the same. The numeration of the months is the following:

January 01
February 02
March 03
April 04
May 05
June 06
July 07
August 08
September 09
October 10
November 11
December 12