Demographic Information
Name:..................................................................
Sex:.......................................
Date of birth:.....................................................
Age:......................................
Marital Status:
Married:
YES/NO
Length of marriage:...............................
Type of marriage:
(civil marriage):
(traditional marriage):
YES/NO
YES/NO
(polygamous marriage):
YES/NO
If not married:
Single:
YES/NO
Divorced:
YES/NO
Widowed:
YES/NO
Children:
Number of own children:..................
Number of dead children:.................
Education:
Employment:
Nil education:.........
Employed(as what?)...................
Primary/Secondary/Tertiary
Unemployed(how long?)................
Select target paragraph3
Add to table of contents