Questionnaire Text

Questionnaire form view entire document: text image

Questionnaire Identification

Province Name
District Name
Province _
District _ _
Constituency _ _ _
Ward _ _
CSA No. _ _
Region:

[]Urban
[] Rural

SEA No. _
Census Building Number (CBN) _ _ _
Housing Number Unit (HUN) _ _
Household Number (HHN) _

Questionnaire instructions view entire document: text image

4.2.4 Rural/Urban
Shade appropriately in the provided boxes for rural or urban, depending on the area in which you are operating. You will transfer this information from the map you are using onto the Form.