NAME OF LOCALITY ______
NAME OF HEAD OF HOUSEHOLD ______
HOUSEHOLD NUMBER ______
CONCESSION NUMBER ______
CLUSTER NUMBER ______
HEALTH DISTRICT ______
URBAN/RURAL (URBAN = 1, RURAL = 2) ENVIRONMENT ______
DAKAR/REGIONAL CAPITAL/OTHER CITY/RURAL
(DAKAR = 1, REGIONAL CAPITAL = 2, OTHER CITY = 3, RURAL = 4) DETAILED ENVIRONMENT ______
NAME AND LINE NUMBER OF WOMAN ______
CLUSTER NUMBER IN DHS-IV 2005 ______
HOUSEHOLD SURVEYED IN DHS-IV 2005? (YES = 1, NO = 2) ______
HOUSEHOLD NUMBER IN DHS-IV 2005 ______
WOMAN SURVEYED IN DHS-IV 2005? (YES = 1, NO = 2) ______
WOMAN'S LINE NUNBER IN DHS-IV ______