NAME AND CODE OF REGION ____
CAPRIVI 01
ERONGO 02
HARDAP 03
KARAS 04
KHOMAS 05
KUNENE 06
CHANGWENA 07
KAVANGO 08
OMAHEKE 09
OMUSATI 10
OSHANA 11
OSHIKOTO 12
OTJOZONDJUPA 13
NAME OF VILLAGE/TOWN/CITY __________
URBAN 1
RURAL 2
LARGE CITY/SMALL CITY/TOWN/RURAL
LARGE CITY 1
SMALL CITY 2
TOWN 3
RURAL 4
HOUSEHOLD NUMBER ____
NAME AND LINE NUMBER OF WOMAN_____