New Form 1New Form 11) District identifier code2) Interviewer: Have you read out consent form?YesNoHouseholds3) Add another householder member?3.1) Is [NAME] male or female?MF3.2) How old is [NAME]?3.3) Has [NAME] missed school because of sickness over the last 7 days? YesNo4) What is this household's main water supply?a) Indoor tapb) Outdoor tapc) etc121212123