817F) Where can you go for this test?
RECORD ALL MENTIONED.
817FX) Where did you go for this test?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
NAME OF PLACE____
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MATERNITY D
MOBILE CLINIC E
FIELDWORKER F
OTHER (SPECIFY)_____ G
PRIVATE MEDICAL SECTOR
CLINIC H
PHARMACY I
PRIVATE DOCTOR J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) ______ L
COMMUNITY SECTOR
HEALTH CENTER M
HEALTH WORKER N
ADBC/MATRON/MIDWIFE/NURSE'S AIDE O
PARA-PUBLIC SECTOR
INFORMATION AND ADVICE CENTER P
PNLS (NATIONAL PROGRAM AGAINST AIDS) Q
OTHER (SPECIFY)_____ R
OTHER SOURCE
SHOP/MARKET S
TRADITIONAL PRACTITIONER T
CHURCH U
RELATIVES/FRIENDS V
OTHER (SPECIFY) _____ X