Questionnaire Text

Burkina Faso 2014 Ethiopia 2014a Indonesia 2015 Nigeria 2014b
Burkina Faso 2015 Ethiopia 2014b Indonesia 2016 Nigeria 2015a
Burkina Faso 2016a Ethiopia 2015 Kenya 2014a Nigeria 2015b
Burkina Faso 2016b Ethiopia 2016 Kenya 2014b Nigeria 2016
Congo (Democratic Republic) 2013 Ethiopia 2017 Kenya 2015a Nigeria 2017
Congo (Democratic Republic) 2014 Ghana 2013 Kenya 2015b Uganda 2014
Congo (Democratic Republic) 2015a Ghana 2014a Kenya 2016 Uganda 2015a
Congo (Democratic Republic) 2015b Ghana 2014b Niger 2015 Uganda 2015b
Congo (Democratic Republic) 2015c Ghana 2015 Niger 2016a Uganda 2016
Congo (Democratic Republic) 2016a Ghana 2016 Niger 2016b Uganda 2017
Congo (Democratic Republic) 2016b India 2016 Niger 2017
Cote d'Ivoire 2017 India 2017a Nigeria 2014a
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Burkina Faso 2014
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Burkina Faso 2015
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Burkina Faso 2016a
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Burkina Faso 2016b
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Congo (Democratic Republic) 2013

No questionnaire text is available for this sample.


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Congo (Democratic Republic) 2014
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Congo (Democratic Republic) 2015a
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Congo (Democratic Republic) 2015b
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Congo (Democratic Republic) 2015c
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Congo (Democratic Republic) 2016a
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Congo (Democratic Republic) 2016b
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Cote d'Ivoire 2017
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Ethiopia 2014a
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Ethiopia 2014b
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Ethiopia 2015
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

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Ethiopia 2016
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Ethiopia 2017
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Ghana 2013
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Ghana 2014a
Questionnaire form view entire document:  text 

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM

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Ghana 2014b
Questionnaire form view entire document:  text 

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM

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Ghana 2015
Questionnaire form view entire document:  text 

Record the correct date and time.

Day____
Month____
Year____
Hours____
Min____
AM/PM____

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Ghana 2016
Questionnaire form view entire document:  text 

Record the correct date and time.

Day____
Month____
Year____
Hours____
Min____
AM/PM____

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India 2016
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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India 2017a
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Indonesia 2015
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Indonesia 2016
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Kenya 2014a
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Kenya 2014b
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Kenya 2015a
Questionnaire form view entire document:  text 

Record the correct date and time.

Day____
Month____
Year____
Hours____
Min____
AM/PM____

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Kenya 2015b

No questionnaire text is available for this sample.


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Kenya 2016
Questionnaire form view entire document:  text 

Record the correct date and time.

Day____
Month____
Year____
Hours____
Min____
AM/PM____

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Niger 2015
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Niger 2016a
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Niger 2016b
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Niger 2017
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Nigeria 2014a
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Nigeria 2014b
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Nigeria 2015a
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Nigeria 2015b

No questionnaire text is available for this sample.


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Nigeria 2016
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Nigeria 2017
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Uganda 2014
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Uganda 2015a
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Uganda 2015b
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


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Uganda 2016
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM


top
Uganda 2017
Questionnaire form view entire document:  text 

D. Current date and time: Is this date and time correct?
[ODK will display on screen]

[] Yes 1
[] No 0

E. Record the correct date and time.
Date
Month____ Day____ Year____
Time
Hours____ Minutes____ AM/PM