‘Questiounaire fer Clinic Key Holder - Page 3

19.

Sex:

( ]
{ ]

Male

Female

20.

Years of aducation.

21.

Years of medical training or health training.
Highest degree or certificate obtained ia
medical field.

22.

23.

Place of medical training.

24.

25.

Years of axperience in healch work.
How wall would this person cooperace with clinic workers?

{ ]

Good

{ ]

Poor

{ ]

26.

Fair

How well is chis person accepted by the people?
{ ]
{ ]
{ ]

Good
Fair
Poor

CONTINUE ON S8ACK_ IF MORE SPACE IS NEEDED

27.

Is a clinic worker of either sex acceptable with the people?

{ ]
{ ]
28.

Yes
Mo

Tf ne, specity preferred sex:

( ]

{ ]

Male

Female

Select target paragraph3