330. Where is this place? Any other place?
IF THE SOURCE IS A HOSPITAL, A HEALTH CENTER OR A CLINIC, WRITE THE NAME OF THE ESTABLISHMENT. PROBE TO DETERMINE THE SECTOR AND CIRCLE THE APPROPRIATE CODE.
RECORD ALL PLACES MENTIONED.
NAME OF ESTABLISHMENT__
PUBLIC SECTOR
NATIONAL HOSPITAL A
REGIONAL HOSPITAL B
CSREF (heath referral center) C
MATERNITY D
CSCOM (Centre de Santé Communitaire) Community Health Center E
OTHER PUBLIC (SPECIFY)__F
PRIVATE SECTOR
PRIVATE HOSPITAL/CLINIC G
DOCTOR'S OFFICE H
HEALTH WARD I
PHARMACY J
MOBILE CLINIC K
OTHER PRIVATE (SPECIFY)__L
OTHER SOURCE
SHOP M
BAR/NIGHTCLUB N
KIOSK O
AMBULENT SALESPERSON P
ADBC AGENTS DE DISTRIBUTION À BASE COMMUNAUTAIRE (MOBILE COMMUNITY HEALTH DISTRIBUTION Q
FRIEND/ACQUAINTANCE/RELATIVE R
OTHER (SPECIFY)__X