Questionnaire Text

Questionnaire form view entire document:  text  image

Questions 15-17 are only for women 12 years of age and older


17. Have you given birth to any child born alive in the last 12 months?

[] Yes - How many?

[] 1
[] 2
[] 3 or more

[] No

Questionnaire instructions view entire document:  text  image

Questions 15-17 are only for women 12 yrs of age and older


Question No.17

[Recent births]
[The instructions refer to a graphic of section VI, question 17 on the census form.]

-- Fill in the cell that corresponds to the answer given:

-- If the answer is yes, ask how many and fill in the corresponding cell.