1 - ESDS

1 - ESDS 1 - ESDS

24.08.2013 Views

MWQSKID Havmyou any s@, hstm or adnwd dmdren for any agmwho Iwawth you? Yes 1% Go to MWK)9PER No 99% Ga to MW210 k PLEASE ENTER THE DETAILS OF YOUR SIEP/FOSIER/ADOPlE12 I Total nmnber of CHILO(REN) BELOW children MWQ9PER Enter the chIM’silrstname MWQSSTE HW91MIS MwasBTR tAWQSLf#f Data Ofbwth Data hwahatagsn Irvingtih you slap Fostar Adapted Yaw MonLh Year Isl child 19 [a [q [0] 19 Znd child . ------ + 1 - 3rd chtld -— --- ~ ~ I I 19 19 IQ 4th chdd .. . . . . . 19 ! 19 19 mlo H-v. you aver had a baby? D NOTE. Ev@nII you have had a baty who only Iwad fora shorl time, phasa nng1 A stlllbombnty shouldnot b tndudad Plm” nng 2 If m Iwabombaby —GOtOMwalo Yes. h,”- had ●baby 84s Go 10M~ll NO No, havo nevarhad a b-by 16% Insoudl.am on nmt pmga k MWQ

(A) (s) (c) 1 I Child Firstbom Second born I Imitd bem Fourthborn Fifthborn Stdh born Seventh born Eighth barn Ninth bam P~emll Plearn remrd me follmv.iqdafaib foreach .afme childrenyou hava gNon Mth to in me gtid bolnw (sfatiw wlh me oldesttiiid) #WQ12M MQ12YF (AI Da@ of bitih M.mfh Year .... ... .. 19........ TfM data of bi!th - mnfarMonth and Year Total ntmnbwof Thas8x-ftng lfOr Ma19,2fOr Fm’@a childmo Is fhaf child living with you or not? hfwalzs (0) sax M F Missing se% 4*% 1% 42% 5TS 1% P4 [241 [0] [11] [16] [1] M [4] [01 [2] [3] [0] [1] [1] [0] [t] [0] [0] [01 [1] [0] [1] [q [0] SI% 4s% 1% lNSTRUCTfONS Yes - if you am aged ~ or ovef ptaa8eMum the formto tie intewioww. . Ifyou am agad tS4S, and have ever givenbirthto a baQ pbasa go to Qwdlan MkW213below. hTWQ12L (c) Is your child living with YOUOr nOfrmg appr0pna29 ntunlmr? dS&&9 decN&ud Mfssing 79% 18% 2% 1% 6s% 13% 1% 1?4 p2] [q [0] [0] ml [4] [1] [0] m [a [0] [01 [4] [1] [0] [0] [2] [0] [0] [0] [1] [0] [0] [0] [1] [0] [0] [0] [1] W1 [0] [0] 83% 15% 1% 1% —GII to tnsbwtiotn bobw 1 I . If you am aged 1S4S, and havo neverhad a baby plea8ago to QuestionMVWX22. I I I 1 I M-VJQ13 TO TNOSE WfiO HAVE HAD A EASY Armyou pfmgnantn0w7 4 m

(A)<br />

(s)<br />

(c)<br />

1<br />

I<br />

Child<br />

Firstbom<br />

Second born<br />

I<br />

Imitd bem<br />

Fourthborn<br />

Fifthborn<br />

Stdh born<br />

Seventh born<br />

Eighth barn<br />

Ninth bam<br />

P~emll<br />

Plearn remrd me follmv.iqdafaib foreach .afme childrenyou hava<br />

gNon Mth to in me gtid bolnw (sfatiw wlh me oldesttiiid)<br />

#WQ12M MQ12YF<br />

(AI<br />

Da@ of bitih<br />

M.mfh Year<br />

.... ... .. 19........<br />

TfM data of bi!th - mnfarMonth and Year Total ntmnbwof<br />

Thas8x-ftng lfOr Ma19,2fOr Fm’@a childmo<br />

Is fhaf child living with you or not?<br />

hfwalzs<br />

(0)<br />

sax<br />

M F Missing<br />

se% 4*% 1%<br />

42% 5TS 1%<br />

P4 [241 [0]<br />

[11] [16] [1]<br />

M [4] [01<br />

[2] [3] [0]<br />

[1] [1] [0]<br />

[t] [0] [0]<br />

[01 [1] [0]<br />

[1] [q [0]<br />

SI% 4s% 1%<br />

lNSTRUCTfONS<br />

Yes<br />

- if you am aged ~ or ovef ptaa8eMum the formto tie intewioww.<br />

. Ifyou am agad tS4S, and have ever givenbirthto a baQ pbasa go<br />

to Qwdlan MkW213below.<br />

hTWQ12L<br />

(c)<br />

Is your child living with YOUOr nOfrmg<br />

appr0pna29 ntunlmr?<br />

dS&&9 decN&ud<br />

Mfssing<br />

79% 18% 2% 1%<br />

6s% 13% 1% 1?4<br />

p2] [q [0] [0]<br />

ml [4] [1] [0]<br />

m [a [0] [01<br />

[4] [1] [0] [0]<br />

[2] [0] [0] [0]<br />

[1] [0] [0] [0]<br />

[1] [0] [0] [0]<br />

[1] W1 [0] [0]<br />

83% 15% 1% 1%<br />

—GII to tnsbwtiotn bobw<br />

1 I<br />

. If you am aged 1S4S, and havo neverhad a baby plea8ago to<br />

QuestionMVWX22. I I<br />

I 1<br />

I<br />

M-VJQ13 TO TNOSE WfiO HAVE HAD A EASY<br />

Armyou pfmgnantn0w7<br />

4<br />

m

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