Questionnaire Text

Questionnaire form view entire document:  text  image

Section I: Mortality in the last 12 months - (between February 2006 and March 2007)


M-00 Has any member of this household passed away in the last 12 months between February 2006 and March 2007?

Mark appropriate box with an X
If no, the questionnaire is completed. Thank the respondent(s).
[] Yes
[] No


M-01 How many members passed away?

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Questionnaire instructions view entire document:  text  image

(M-00) Has any member of this household passed away in the last 12 months?
If "No", the questionnaire is complete. Thank the respondent(s).


(M-01): How many members passed away?
If "Yes" on M-00, write the number in the box.