1 - ESDS

Quest~Oma.ra R*f Codtig Sheet No of
Q8
Q9
Q1O
Qll
Quaatxon No Referenca Boxaa/ Co&rig Instructions/Remarks
Characters
I
2
Q9 2
I I 1
I
I
Q1O
Qll
Q12 Q12 No
I
2
2
2
I
.,
Valuas -3-03
In child llving w~th
in formnt ?
Yen ....... ... ........... 01
No ...................... 02
Deceanmd ................ 03
Rmpmat above Mstructxons
for Q8 for each Subseguant
child, in deacanding aga
ordmr . If there arm morm
than twelve children
uwolved ref*r to suparv>sor
Values -- o~
Aro you pragnant nw?
Yam ..................... 01
No or unmure ............ 02
v
--
I “uee 3 ‘a
Th>nk you WL1 1 havm any more
children, after tha one you
u- ●spcting?
Y9m ........ ............. 01
Probsbly Y-s ............ 02
Probably Not ............ 03
NO ...................... 04
Don’ t know .............. 05
wee -- 02
Will probably or probab 1y
not have any moro ch~ldran?
Proba.bly ............. .. 01
Probably Not ............ 02
Values -3-20
Numb-r of chLldran you think
you WL1l have ~n all?
Entmr numb-r of children
204