Literal question
<span class="h1"> Form B: Household questionnaire Part 2</span></p>
<p><span class="em">For all persons</span>
<br />[Questions 10 to 23 were asked of all persons]</p>
<p>[12] Place of birth </p>
<div class="i1">[] 1 In this village<br />[] In another village</div><div class="i2">Give the name of the district of that village and write name of province within brackets ____ _ _ _ _</div><div class="i1">[] Outside Cambodia</div><div class="i2">Write the name of the country ____ _ _ _ _</div>