Literal question
INTERVIEWER VISITS:
FIRST VISIT
DATE____
INTERVIEWER'S NAME____
RESULT*
NEXT VISIT:
DATE____
TIME____
SECOND VISIT
DATE____
INTERVIEWER'S NAME____
RESULT*
NEXT VISIT:
DATE____
TIME____
THIRD VISIT
DATE____
INTERVIEWER'S NAME____
RESULT*
FINAL VISIT
DAY____
MONTH____
YEAR____
INT. NUMBER____
RESULT____
TOTAL NUMBER OF VISITS____
*RESULT CODES
1 COMPLETED
2 NO HOUSEHOLD MEMBER AT HOME OR NO COMPETENT RESPONDENT AT HOME AT TIME OF VISIT
3 ENTIRE HOUSEHOLD ABSENT FOR EXTENDED PERIOD OF TIME
4 POSTPONED
5 REFUSED
6 DWELLING VACANT OR ADDRESS NOT A DWELLING
7 DWELLING DESTROYED
8 DWELLING NOT FOUND
9 OTHER (SPECIFY) _________