Questionnaire Text

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e. This house is in

[] 1 Municipal Area
Name of M.A. ____
[] 2 Sanitary District
Name of S.D. ____
[] 3 Outside M.A. or S.D.
Questionnaire instructions view entire document:  text  image
e) This house is in a municipal area ____
Name of municipality ____
In sanitary area ____
Name of sanitary Area ____
Non-municipality/sanitary area ____