1112. Where is that?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME AND/OR LOCATION OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
NAME AND/OR LOCATION OF PLACE____
GOVERNMENT
HOSPITAL 11
HEALTH CENTER 12
HEALTH STATION/CLINIC 13
HEALTH POST 14
COMMUNITY-BASED OUTLET 15
OTHER GOVERNMENT (SPECIFY)__________ 16
NONGOVERNMENTAL (NGO)
HEALTH FACILITY 21
COMMUNITY-BASED OUTLETS 22
OTHER NGO (SPECIFY)___________________ 26
PRIVATE MEDICAL
PRIVATE HOSPITAL 31
PRIVATE DOCTOR 32
PHARMACY 33
OTHER PRIVATE MEDICAL (SPECIFY) ________ 36
OTHER SOURCE
DRUG VENDOR 41
SHOP 42
FRIEND/RELATIVE 43
OTHER (SPECIFY) ________ 46