Questionnaire Text

Questionnaire form view entire document: text image

VI-A: All ages
[Questions 1-13.]

1. Relation to the head of household:

[] 1 Head of household
[] 2 Wife/husband
[] 3 Children
[] 4 Son/daughter in-law
[] 5 Grandchildren
[] 6 Parent/in-law
[] 7 Other relative
[] 8 Household servant
[] 9 Other

12. Biological mother lives in this household?

[] 1 Yes
[] 2 No (skip to question 14)

13. Name of biological mother: ____

[Question 13 was asked of persons whose biological mother lives in the same household, per question 12.]

Serial number of biological mother: ____

Questionnaire instructions view entire document: text image

Question 12: Mother lives in the current household
Ask the respondent if his/her mother lives in this household. If "Yes", circle code 1 and put the code into the available box. If "No", circle code 2 and put the code into the available box, and continue to Block VIb.

Question 13: Name and serial number of mother
If in question 12 the answer is "Yes", write down the name and serial number of the respondent's mother in the available space. Name and serial number of the mother are taken from Block III column (2) and column (1). Put serial number into the box.