Questionnaire Text

Questionnaire form view entire document: text image

15. a. Full name of dead person

____

b. Sex

[] 1 Male
[] 2 Female

Questionnaire instructions view entire document: text image

a) First name and last name of the dead person:
In case a newborn died before being given a name, interviewers fill out the father's (or mother's) surname followed by three dots (. . .)

b) Sex