11.07.2015 Views

Afghanistan Mortality Survey 2010 - Measure DHS

Afghanistan Mortality Survey 2010 - Measure DHS

Afghanistan Mortality Survey 2010 - Measure DHS

SHOW MORE
SHOW LESS
  • No tags were found...

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

AFGHANISTAN MORTALITY SURVEYWOMAN'S QUESTIONNAIRETHE MINISTRY OF PUBLIC HEALTHApril 14 <strong>2010</strong>IDENTIFICATIONVILLAGE / NEIGHBORHOOD [MUQATAA / MAHALAH]NAME OF HOUSEHOLD HEADCLUSTER NUMBER [SAHA SHOMOR] . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .STRUCTURE NUMBER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .HOUSEHOLD NUMBER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .LINE NUMBER AND NAME OF WOMAN FROM HOUSEHOLD QUESTIONNAIRE________________________________________INTERVIEWER VISITS1 2 3FINAL VISITDATEDAYMONTHINTERVIEWER'SNAMERESULT*NEXT VISIT: DATETIMEYEARINT. NUM.RESULTTOTAL NUMBEROF VISITS*RESULT CODES:1 COMPLETED2 NOT AT HOME AT TIME OF VISIT3 POSTPONED4 REFUSED5 PARTLY COMPLETED7 INCAPACITATED6 OTHER(SPECIFY)LANGUAGE OF INTERVIEWLANGUAGE OFQUESTIONNAIRE:3LANGUAGE OFINTERVIEW:LANGUAGE OFRESPONDENTLANGUAGE CODES: PASHTU = 1, DARI = 2, ENGLISH = 3, OTHER = 4(SPECIFY)TRANSLATOR USED: (YES = 1, NO = 2)SUPERVISORFIELD EDITOROFFICEEDITORKEYED BYNAMENAMEAppendix F |215

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!