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Quastaonna~rm Raf<br />

>$<br />

I Cochng Shaet I NO of<br />

*.%<br />

Quaatxon No<br />

R-f ●rancm<br />

Boxasf<br />

Characters<br />

Coding Instructions/Ramarks<br />

I<br />

I<br />

I<br />

Q34 Q34(4] 2 Valuee .- 13<br />

Q35<br />

Q36<br />

Q35<br />

Q36 Meth<br />

2<br />

2<br />

Which ❑cthoda of prevent mg<br />

pragnancy ware you us mg?<br />

W~thdrawal .............. 01<br />

Shmath/condom ........... 02<br />

Safe pariod/rh@un<br />

mthod ................. 03<br />

Cap/dzaphragm ........... 04<br />

Contracaptivc sponga .... 05<br />

141nL pill (progastarone<br />

only ) ................. . 06<br />

ComhLndd PI11 ........... 07<br />

Not sure if mLnL or<br />

comhmed pLll .......... 08<br />

IW/COLl/Lntra-uterLne<br />

dmv~cm ................. 09<br />

Foanu/g91s/9prays/<br />

Pasaarlu (sprm~cades ). 10<br />

In]ectionn .............. 12<br />

Anothar mathod .......... 13<br />

Method of contracept~on<br />

used?<br />

Only u-ad on= mathod .... 01<br />

Us@d mora than ona method 02<br />

Somatimmm ona mmthod<br />

●ometmmm another ...... 03<br />

Which mathod did you US=<br />

momt often?<br />

Enter tha numhr of tha<br />

method<br />

’212

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