Questionnaire Text

Questionnaire form view entire document: text image

19. Does this household possess a . . .

Washing machine?

[] 1 Yes
[] 2 No

Questionnaire instructions view entire document: text image

Question No. 19: Does this household possess a . . ?

What is wanted from this question is to gather information about the existence of appliances that offer members a large convenience.
Ask the question as it is written and read all the appliances that are included in the questionnaire.
Mark with an "X" the circles agreeing with the responses that the person gives you.
If a person states that any appliance is broken, ask if it has been repaired. If the response is affirmative, mark " yes", and if contrary mark " no".
Remember that there can be more than one response for this question.

[Below the text are pictures of an electric fan, portable stereo, washing machine, car, a man with a cell phone, computer, calculator and television set.]