Questionnaire Text

Questionnaire form view entire document:  text  image

28. On what date was your last born-alive child born?
Write the response given by the respondent.

Day ____
Month ____
Year ____

Questionnaire instructions view entire document:  text  image

For women 15 years of age or older
(Apply to questions 26-29)


Question 28 On what date was your last born-alive child born?

Write down in the corresponding space the day, month and year in which was born your last child born alive.