1 - ESDS

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Qu*8t10nnair9 Raf
Quaataon No
QIA
QIB
CHECX A
Q2
CHECK B
Codxng Shaat
Ref ●r*nc _
QIA
QIB
CHK A
Q2
CHX B
No of
Box9s/
Cbarmctms
2
2
2
2
2
Codxng Instructions/R~rks
Chzldran undar 12 in the
housahold
Ym . ............... ........ol
No ... .............. ........02
1s th~s inf ornmnt the
praon reqmxtaible for tho
children?
Yaa .. .............. ........ol
No .. ......... ..... .........02
Valuea -4-05
Hut many childran ●gmd undar
5 is tha informant
r.mponuble for?
Entm number
None ......... ......... .....-4
Make arrangements for your
undar 5 ‘●?
Yea . . . . . . . . . . . . . . . . . . . . ...01
No . . . . . . . . . . . . . . . . . . . . . ...02
Values -4-05
How many ch>ldren aged 5-11
in ~nformant respons~ble
for?
Enter number.
Norm . . . . . . . . . . . . . . . . . . . ...-4
232