Questionnaire Text

Questionnaire form view entire document:  text  image
6. Birthplace
State district if born in Zambia and district number and country if outside of Zambia:
District Name:_____________
Code:_ _

Was this part of the district rural or urban at the time of birth?
[] Rural
[] Urban
[] N/A (outside Zambia)
Questionnaire instructions view entire document:  text  image
P6: Where was born? (Birth Place)

In this question, "Place" refers to district for cases within Zambia, or country for cases outside Zambia whether the person is Zambian or not. For persons born in Zambia, write the district of birth and then shade the appropriate space. The district codes are provided in Appendix 1. Some people may not know the name of the district in which they where born, but they generally know the name of the Chief s area. In such cases you should write out Chiefs area and then later on refer to the list of Chiefs by districts in Appendix 5, and find out which district the Chief belongs to. In case the person was born outside Zambia, write the name of the country in which he/she was born. Then write the name of the country, its code and shade the appropriate country code in the space provided. The country codes are given in Appendix 6. Do not write the name of the district of a foreign country.