Questionnaire for Clinic Kay Holder - Page 4
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29.
Would the people be willing for a male nurse co deliver babies?
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30.
Would che people accepe family planning and sex education from a heaith
worker of either sex?
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31.
Yes
No
Yes
No
Tf no, specify sex preference:
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Males can do famtly planning and sex education for both sexes
Females can do family planning and sex education for beth sexes
“Must have male workers for male patients and female workers for
female patients
32.
Number of people in clinic serving area
33.
Number of births per month in clinic serving area
34,
number of deliveries per month at clinic
35.
Number oz deaths per month in clinic serving area
36.
Whe records births and deachs?
Who determines cause of death?
38.
Is this information recorded on a death certificate?
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39.
Yes
Yo
Where are records of births and deaths kepc?