Questionnaire Text

Questionnaire form view entire document:  text  image

2. What is this person's age and what is this person's date of birth? Print numbers in boxes.
Age (in years) _ _ _
Month _ _ Day _ _Year of birth _ _ _ _
Questionnaire instructions view entire document:  text  image

2. For each person, print the age at last birthday (print "00" for babies younger than 1 year old). Also print the month, day, and year of birth.