DOCTOR VISITS (1)
1. Person number ____
First visit ____
Record each date on which a doctor was visited in a separate question 2a.
Earlier you told me that -- had seen or talked to a doctor during the past 2 weeks.
2a. On what (other) dates during that 2-week period did -- visit or talk to a doctor?
b. Were there any other doctor visits for -- during that period?
 No (As 3-6 for each visit)
3. Where did he see the doctor on the (date), at a clinic, hospital, doctor's office, or some other place?
20 Doctor's office
30 Pre-paid Ins. Group.
40 Hospital Out-patient Clinic
50 Hospital Emergency Room
60 Health Department
70 Company or industry
80 Other (Specify) ____
4a. How much was the doctor's bill for that visit (call)?
If bill not received, ask:
b. How much do you expect the doctor's bill to be for that visit (call)?
5. Is the doctor a general practitioner or a specialist?
What kind of specialist is he?
6a. Why did you visit (call) a doctor on (date)?
Write in and mark appropriate box(es). ____
2 Pre or Postnatal care (Next DV)
3 General checkup (Next DV)
4 Eye exam. (glasses) (Next DV)
5 Immunization (Next DV)
6 Other (Next DV)
If 2 or more doctor visits for person and no condition reported in 6a, ask:
b. For what condition did -- visit the doctor on this date?