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Christian Mission Aid CMA - Action Against Hunger

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24.IX.2. Anthropometric Survey QuestionnaireDATEVILLAGE:N°.12345678910111213141516171819202122232425262728293031FamilyN°.Status(1)TribeAgeMthsSexM/FWeightKgHeightcmCLUSTER No:TEAM No:SittingHeightcm (2)Oedema Y/NMUACmmMeaslesC/M/N(3)(1) Status: 1=Resident, 2=Displaced (because of fighting, length < 6 months), 3=Family temporarilyresident in village (cattle camp, water point, visiting family…).(2) Sitting Height is optional. To apply for ACF-USA survey. This data is for research.(3) Measles*: C=according to EPI card, M=according to mother, N=not immunized against measles.

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