NAME OF REGION ______
NAME AND NUMBER OF HEAD OF HOUSEHOLD ______
CONCESSION NUMBER ______
CLUSTER NUMBER ______
REGION ______
DEPARTMENT ______
HEALTH DISTRICT ______
URBAN/RURAL (URBAN = 1, RURAL = 2) ______
DAKAR/REGIONAL CAPITAL/OTHER CITY/RURAL
(DAKAR = 1, REGIONAL CAPITAL = 2, OTHER CITY = 3, RURAL = 4)______
NAME AND LINE NUMBER OF WOMAN ______