2-WEEKS DOCTOR VISITS PAGE
[MK Note: There are two columns to fill in information for 2-WEEKS DOCTOR VISITS. The same information is included in both columns, therefore, the second column is omitted here.]
Earlier, you told me that -- had seen or talked to a doctor during the past 2 weeks.
7777  Last week
8888  Week before
b. Were there any other doctor visits for him during that period?
 N (As 3-6 for each visit)
If Hospital: Was it the out-patient clinic, or the emergency room?
If Clinic: Was it a hospital out-patient clinic, a company clinic, or some other kind of clinic?
1  Doctor's office (group practice or doctor's clinic)
2  Telephone
3  Hospital Out-Patient Clinic
4  Home
5  Hospital Emergency Room
6  Company or Industry Clinic
7  Other -- Specify ____
 Specialist -- What kind of specialist is he? ____
2  N
Mark appropriate box(es)
3  General checkup (6b)
2  Pre or Postnatal care (Next DV)
4  Eye exam. (glasses) (Next DV)
5  Immunization (Next DV)
6  Other ____ (Next DV)
b. Was this for any specific condition?
 N (Next DV)
Mark box or ask:
c. For what condition did -- visit the doctor on this date? ____