Questionnaire Text

Questionnaire form view entire document:  text  image
5. Does your household have?..?
Indicate with "Yes or "No".

Electricity? ____
A radio? ____
A television? ____
A refrigerator? ____
A telephone? ____
A bicycle? ____
A motor vehicle? ____
A motorcycle? ____
A plough? ____
A boat/canoe? ____
A scotch cart? ____
A donkey? ____
Questionnaire instructions view entire document:  text  image
HH5: Does your household have?

Find out whether the household has any of the listed items and shade appropriately.