|
Q0401
|
|
What is the total Number of people who live in this household? |
|
Q0402
|
|
What is the name of the head of the household? |
|
Q0402A
|
|
Surname (last name): |
|
Q0402B
|
|
First (given) name: |
|
Q0403
|
|
First name and surname |
|
Q0403A
|
|
First name |
|
Q0403B
|
|
Surname |
|
Q0404
|
|
Person number |
|
Q0405
|
|
What is [NAME]'s relationship to the household head? |
|
Q0406
|
|
Is [NAME] a male or a female? |
|
Q0407
|
|
How old is he/she? (if less than 1 year old enter "00") |
|
Q0408
|
|
What is [NAME]'s marital status? |
|
Q0409
|
|
What is the highest level of education [NAME] completed? |
|
Q0410
|
|
Eligible for selection? |
|
Q0411
|
|
Does [NAME] have health insurance coverage? |
|
Q0412
|
|
Does [NAME] need care due to his/her health condition? |
|
Q0413
|
|
How much care does he/she need? |
|
Q0414
|
|
Is [NAME] presently in an institution due to his/her health condition? |
|
Q0415
|
|
What is the reason for [NAME]'s absence? |
|
Q0416
|
|
Where did [NAME] go to? |
|
Q0417
|
|
Are there any other persons such as small children or infants that we have not listed? |
|
Q0418
|
|
Are there any other persons not here at the moment that is usually part of your household? |
|
Q0419
|
|
Who is the main income earner for the household? |
|
Q0420
|
|
Who is the household member who completed the household roster? |
|
Q0421
|
|
Has any member of this household died in the last 24 months? |
|
Q0422
|
|
How many deaths were there in the household in the last 24 months? |
|
Q0423
|
|
Sex of deceased |
|
Q0424
|
|
What was his/her age at death? |
