Survey Text

1983
top
1983
Survey form view entire document:  text  image
Hand calendar.
10a. Did you have a drink during the 2-week period [outlined on that calendar/beginning Monday, (date) and ending Sunday (date)]?

1[] Yes
2[] No (10c)

b. During that period, when did you last have a drink?

Month ____
Date ____
Year 19__