Questionnaire Text

Questionnaire form view entire document: text image

For Every Person
[Questions L1- L7 were asked of every person.]

L1. Line number _ _ _ _

Questionnaire instructions view entire document: text image

Columns 1 - 7 Interview and record the detailed information of every household member.

Column 1 Order no.

The order numbers 1 - 10 are printed. Person no. 10, fill number 1 before number 0. If any household has members more than 10, add order numbers 1, 2, 3 as 11, 12, 13 in sheet number 2 and the following sheets of the PHC 2S Form by adding the front digit to

p. 65

make them 11, 12, ..., 20 etc. (Circle order number of the interviewee. If there are many interviewees, circle one order number only).