PUBLIC SECTOR

GOVERNMENT HOSPITAL/CLINIC A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST C
MOBILE CLINIC D
COMMUNITY HEALTH CENTER E

MEDICAL PRIVATE SECTOR

PRIVATE HOSPITAL F
PHARMACY/DRGST./CHEMIST G
PRIVATE DOCTOR/CLINIC H
MOBILE CLINIC I
COMMUNITY HEALTH WORKER J

OTHER PRIVATE SECTOR

SHOP K
TRADITIONAL PRACTITIONER L

OTHER (SPECIFY) _____ M

PUBLIC SECTOR

GOVT./MUNICIPAL HOSPITAL A
PRIMARY HEALTH CENTRE B
SUB-CENTRE C
MOBILE CLINIC D
VILLAGE HEALTH GUIDE E
GOVERNMENT PARAMEDIC F

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC G
PHARMACY/DRUGSTORE H
PRIVATE DOCTOR I
MOBILE CLINIC J
COMMUNITY HEALTH WORKER K

OTHER PRIVATE SECTOR

SHOP L
TRADITIONAL PRACTITIONER M

OTHER (SPECIFY) ________ N

PUBLIC SECTOR

GOVERNMENT HOSPITAL A
PRIMARY HEALTH CENTRE B
DISPENSARY C
OTHER FIXED FACILITY D
MOBILE CLINIC E

MEDICAL PRIVATE SECTOR

PRIVATE HOSPITAL F
PRIMARY HEALTH CENTRE G
DISPENSARY H
PRIVATE DOCTOR I
CHEMIST J
MOBILE CLINIC K

OTHER PRIVATE SECTOR

SHOP L
TRADITIONAL PRACTITIONER M

OTHER (SPECIFY) ____ N
DON'T KNOW O

PUBLIC SECTOR

HOSP./DISTRICT CLINIC A
PRY./HEALTH CENTRE B
HEALTH/SUB-HEALTH POST C
MOBILE CLINIC D
FIELD WORKER E
OTHER PUBLIC (SPECIFY)_________________________F

PRIVATE SECTOR

HOSPITAL G
CLINIC/NURSING HOME H
PHARMACY I
MOBILE CLINIC J
COMM. HEALTH WORKER K
OTHER PRIVATE (SPECIFY)________________________L

OTHER SOURCE

SHOP N
TRAD. PRACTITIONER O

OTHER (SPECIFY)_________________________________X