Literal question
INTERVIEWER VISITS
FIRST VISIT
DATE
INTERVIEWER'S NAME
RESULT*
NEXT VISIT:
DATE
TIME
SECOND VISIT
DATE
INTERVIEWER'S NAME
RESULT*
NEXT VISIT
DATE
TIME
THIRD VISIT
DATE
INTERVIEWER'S NAME
RESULT*
FINAL VISIT
DAY
MONTH
YEAR 206_
INT. NUMBER
RESULT
TOTAL NUMBER OF VISITS
*RESULT CODES:
1 COMPLETED
2 NOT AT HOME
3 POSTPONED
4 REFUSED
5 PARTLY COMPLETED
6 INCAPACITATED
7 OTHER (SPECIFY) _____________
LANGUAGE OF QUESTIONNAIRE: ENGLISH
LANGUAGE OF INTERVIEW _____________
NATIVE LANGUAGE OF RESPONDENT _______________
TRANSLATOR USED
YES 1
NO 2
LANGUAGE CODES:
NEPALI 1
BHOJPURI 2
MAITHILI 3
OTHER 6