1 - ESDS

Q57
I
BABY
Q57 MSNOP
Q57 INFERT
Q57 UNSATIS
Q57
I
I
I
I
RSLIG
Q57 OTHER 2
Q58 QS8 2
I
2
2
2
2
2
Coding Instructions/Remarks
Values -3-01
Code 01 if circled,
otherwise code 00.
Values -3-01
Code 01 if circled,
otherwise code 00.
Values -3-O\
Code 01 if circled,
otherwise code 00.
Values -3-01
Code 01 if circled,
otherwise code 00.
Values -3-0 ~
Code 01 if circled,
otherwise code 00.
Values -3-01
Code 01 if circled,
otherwise code 00.
Values -3-02
Used any methods of
preventing pregnancy?
Yes ......................01
No .......................02