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. NO.___
RESULT___
TOTAL NUMBER OF VISITS__
*RESULT CODES:
COMPLETED 1
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER_____(SPECIFY) 7