Questionnaire Text

Questionnaire form view entire document:  text  image

[Questions S1- S6 were asked of every person.]


S5. What's [respondent's] month and year of birth?

Record month and year of birth.

Month _ _
Year _ _ _ _

Questionnaire instructions view entire document:  text  image

For columns 1-6, ask and record details of everyone.


Column S5: Month and year of birth
Ask: "...... (name) ...... , in what month and year were you born?"
Record the month of birth and year of birth in the columns of month and year, respectively.

1. If the answer is in the lunar month and the zodiac year such as the 12th month of the rabbit year, record "12" in the month column and "rabbit" in the year column.
2. If the answer is in the solar year such as September of the year 2496 B.E. [1953 A.D.], record "September" in the month column and "2496" in the year column.
3. If the person does not know the month of birth, record "X" in the month column, and if she/he does not know the year of birth, record "X" in the year column.

Note: if the person cannot remember the month or year of birth, ask for the copy of the house registration to look for this information.