Questionnaire for Clinic Key Holder ~- Page 2
8.
Years of aducation.
«
sO
Years of nedical training or health training.
1d.
Sighest degree or certificate obtained ia
medical fLeid.
ll.
Place of medical training.
12.
How well would this person cooperate with clinic workers?
rar see
13.
Years of experience in health work.
14.
Good
Fair
Poor
How well is this person accepted by the people?
[ ]
{ ]
{ ]
Good
Fair
Poor
OTHER HEALTH WORKERS
PERSON #2
Primary occupation.
15.
16.
Does this person work in the clinic?
[ ]
[ ]
Yes
No
17.
Bours per week spent in clinic work.
18.
Age