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Questionnaire Re f Question No Q2(A) Q2(A) Q2(B) Q3 Coding Sheet Reference Q2Aii 22Aiii )26 2 , No of Boxes/ Characters 2 2 Coding Instructions/Remarks Sight problems ...........38 Skin problems ............39 Speech impediment ........40 Stomach problems/digestive tract .....-..............41 Thyroid gland ............42 Ulcers (internal) ........43 Ulcerations jabcasses (external) ..............44 Varicose veins ...........45 Other ....................46 Try to fit into the abOve categories before referring to supervisor Values -3-46 Type of illness/disability - second Code as per first illness (2Ai) Values -3-46 rype of illness/disability - third Code as per first illness (2Ai ) Ialues -3-02 >oes it limit ~ay? you in any lAw of the illnesses) res ......................01 {0 .......................02 ralues -3-02 :ut down activities in ;WO weeks because of .llness? ast :es ................... ..01 10.. . .. .. . .. .. . . . . .. .. .. ..02 ~.. Ldtl
1 Q3(A) Q3A Q3(B) Q’ Q4(A) Q4(B) Last (lst) Consult Q’(B) Last (1st ) consult No of . . .. Boxes/ ; Coding In9tructaons/Ramarks Characters .2 I I I Q4 Q4A Q4B PERS 2 I I 1 , I 2 2 2 2 I ‘s ‘3-4’ I What was tha mattgr? Values -3-14 Enter numbmr of days Ln last 2 waaks v s -3-o I alue Talk to a doctor W’cc in last 2 weeks? ram . . . . . . . . . . . . . . . . . . ...01 No ............ ...........02 I (Excludm consultations on I behalf of children under 16 y.ara old) value s -3-IQ Enter numb-r of tl.ms Ln laat 2 woakn Values -- 2 Whosa b-half was most recent consultation? Informant ................01 other H/H membar 16+ .....02 Valu ●, -3-2~ Whona behalf was moat rmcant conaultat~on Entar person numbar of other K/H mmbar. 00 ~f informant 129
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SWQ33 TO 7HOSE WHO HAvE NOT HAO A S
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sWQ41 If you (or your partner) used
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SWQ47 Please put a rtng around the
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&d7
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DWQI ~nldng of your (mast Mant) Man
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DwQi 1 Hava yOUever had a blby? NO=
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owa19 TO TWOSEwHO ARE NOT PREGNANT
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DWQ33NHS Was tie oporatinncati out
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0WQ43 Which of the tilbtig mdwd(s)
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DWQ50 WIIkh of the fallowingmdhod(s
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TO THOSE WliO 00 NOT USE A MEl1100
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Mwm Thinidngof yourpmsmt man?agg,dl
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(A) (s) (c) 1 I Child Firstbom Seco
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MWQ20N0 How many ctwdmndo youminkyo
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W241WH MWQ34PWH Oldyoumldhe hava th
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Mwau Wflcll of thd followingmethod(
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MWQ61 WIIich of ttw foibwingmethod(
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“PP]UOuf-641(b) SG CONTINUOUS HOU
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CONTINUOUS HOUSEHOLD SURVEY i Dotmm
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EOUSEEOLD TYPE A CODE (02-3) Valuas
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Y aa3 m 4 \N 4 \ z uco6 ,
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_— Employment Status ~ EHp —. Q
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— Quastlonnaare R= f Qumst~on No
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Questionnaire Ref Coding Sheet No o
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Questionnaire Ref Question No Q1 Q2
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Questionnaire Ref 1 Coding Sheet No
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Quaat,onnaxra Ref Codang Sheet No o
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Questionnaire Ref Question NO Q1l(A
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Questionnaire Ref Question No Q1l(A
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Quest ionnaire Re f Question No Q1l
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Questionnaire Ref Question No Q1l(A
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Questionnaire Ref Question No Q13 Q
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Questionnaire Ref Coding Sheet NO o
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Questionnaire Ref Coding Sheet Ques
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Questionnaire Ref Coding Sheet No O
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Questionnaire Ref Coding sheet No o
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Questionnaire Ref Question NO Marit
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Questionnaire Ref Question No Stand
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Questionnaire Ref Question No Posit
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All others Those persons not fallin
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Qumst.onna.re Raf — Qu88t&0rJ No
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Quastlonnaare Raf Queatxon No QID Q
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Quastlonnaara R-f Coding Shmt No of
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Quastaomaarm R-f Cod>hg Sheet No of
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Qumst .onna>r. R= f ..-* ! Codzng S
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— Qu9st~onnazre Ref Qumst,on NO Q
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Quastionnamm R-f Qumstxon No Q5(A)
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Q5(A) FRENCH Q5(C) FRENCH Q5(c) (L)
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Qu9staonnaara R-f Q5(A) GREEK Q5(C)
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(p49stn7nnaara Rmf Quostzon No Q5(A
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Quast~omaare Raf Q5(A) SPANISH Q5(C
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Quast~onnaar9 Ref Qumstmn No Q5(F)
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Qucstaonnalre R= f Qu9stxon No Q5(F
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Q.@stzonnaara R-f Qwstaon No Q5(F)
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i, , ‘! Quast>onna2re R-f Codxng
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QuastlonnaLra R@f Questaon No Q5(L)
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Page 129 and 130: Qu.staonnaxrm Ref Q5(N) Q5(N) Q5(N)
Page 131 and 132: Quast>onnaLre R-f Q5(0) Q5(0) Q5(0)
Page 133 and 134: ,.. --- Quastuannmra Raf Cod>ng Sha
Page 135 and 136: QumstaonnaLra Rmf QuastLon No Q6(A)
Page 137 and 138: Q6(A) (ii) Q6(A) (11) Q6(A) (U) Q6(
Page 139: — Quastxonnaarm Ref Cod~ng sheet
Page 143 and 144: Questaonnur, R9f Questaon No Qlc Q2
Page 145 and 146: Q.astuxmaxre Ref Questaon No Q4(A)
Page 147 and 148: . . . + . Quastzonna~r= R-f Codang
Page 149 and 150: Q6 Q6 Q7[A) Q7A Q7(B) Q7B cHECK C C
Page 151 and 152: Quastuanna.ra R-f Q13 Q14 Q15 Quast
Page 153 and 154: Quastzonnaara R-f Questmn No Q18 Q1
Page 155 and 156: Qu*stmnnaLr* R-f Cod~iig Shoat No o
Page 157 and 158: Q19(B) Q19B Q19(B) (i.) Q19(C) Q19C
Page 159 and 160: — Qu8stx0nrIUr9 Raf Quwstaon No Q
Page 161: Quest ~onnalrm Rmf — QumstLOn No
Page 164 and 165: Questiomaire Ref Coding Sheet Quest
Page 166 and 167: Questionnaire Ref 1 Coding sheet No
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Page 172 and 173: Questionnaire Ref Question No Q3B P
Page 175: Quastaonnalre Re f —. Quest~on No
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Page 182 and 183: Questionnaire Ref Question No Codin
Page 184 and 185: Questionnaire Ref Question No Q1O Q
Page 186 and 187: CHILD HEALTH TSE FOLLOWING QUESTION
Page 188 and 189: Questionnaire Ref Question No QIO(A
Page 190 and 191: Quest ionnaire Re f Question No Q12
Page 193 and 194: Quast>onnalr. Ref —. Quastlon No
Page 195 and 196: Questlonna~r9 R-f Q1(A) Qumstaon No
Page 197 and 198: Q2(C) Q3 Q3 Q3A Q3B Q3C -i Cadang S
Page 199 and 200: Questaonnaxrm Ref Qu-st>on No Q4A Q
Page 201 and 202: Qu8staonnaxrm Raf Qumstmn No Q8A Q8
Page 203 and 204: cHSCK F CHECK G Q13 Q13A Q13A CHX F
Page 205 and 206: Questxonnalra Raf Q14C Quest.on No
Page 207 and 208: Quastlonnaare R-f Qu6st~on No Q17 Q
Page 209: — Questuannaxre Ref Coding Shaat
Page 213 and 214: Q.est.m.n~.r= Rmf Quastaon No Q3 Q4
Page 215 and 216: Quastionnaara Ref Questzon No Q1O R
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Page 219 and 220: Q29 Q30 Q31 Q32 Q33 Q34 Ref ●r*nc
Page 221 and 222: Quastaonnaara Raf I Codang Shmat I
Page 223 and 224: Q43 Q43 Q43 Q43 Q44 Q44 Q43 (1) Q43
Page 225 and 226: Qu9sta0nnaar* Raf Qu*staon No Q46 Q
Page 227 and 228: Q51 Q51 Q51 Q52 Q53 Q51 (2) Q51 (3)
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Q56 Q56 Q57 Q58 Q58 Q58 Q58 Codang
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*.. r
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Questionnaire Ref Question No (215
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Questionnaire Ref Question No Q25 (
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Questaonnaira Raf Questmn No Q3 Q4
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Questlonna~re Ref Codxng Shaat No o
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m 23 .+
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Q32 Q33 Q34 Q35 Q35 Q36 cw- Q33 INH
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Q39 (1ST WETHOD) Q39 (2wD-4TH NETHO
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Quastaonnaara Ref Qua=tion No Q44 Q
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Quastaonaaara Ref Cod>ng Shomt Quas
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Quastmmaara Raf mdxng Shaat No of Q
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— Qu9staonnaare R-f QUOStLOll No
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— Qumstxonnaarm Ref Quastlon No P
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Q5 LIVYR Q6 Q6 Q7 Q7N0 Q8 I I Mont
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Questionnaire Ref Coding Sheet Ques
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Questionnaire Re f Coding Sheet No
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Questionnaire Ref Coding Sheet NO o
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Q50 Q50 (1) I I 2 2 Coding Instruct
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— Quastxonnalre Ref Qummtxon No P
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Questionnaire Ref Question No Q5(A)
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Questionnaire Ref Question No Q5(E)
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Questionnaire Ref Question No Q6(C)
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Questionnaire Ref Question No Q6(I)
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Q3(I)(L1) Q3(I) (iii) !23(1 )(111)
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Q3(B) Quastxm No Q3(B) (i) Q3(C) Q3
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Qu9stJonnaarm Raf Quastxon No Q3(G)
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) Questaonnura Ref — Quoatxen No
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Questionnaire Raf Question No Q4(A)
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Questionnaire Ref I Coding Sheet I
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Questionnaire Ref Question No Q1(A)
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