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Download - Yemen Humanitarian Response | YEMEN

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To be filled by the Team Leader (for data input purposes)Repeated absence of the household even after the second visit (1=yes, 2=no)Consent (1=yes, 2=no)Team NumberHouseholdQuestionnaire NumberDate of Interview day Month yearØ 2 Ø 1 2Is the region urban (1) or rural (2)?Village or neighborhoodSub-district codecode numbernumberDistrict codeGovernorate codenumberSurvey zone (stratum)Cluster numbernumberStratum number is (1) for Mountainous Zone and (2) for Lowland Zone2 5………………………………………………………………………………………………………………………………………………….………Desk workName day month Year SignatureData entryReviewOther encodingRemarks:………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………65

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