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Unmet Form

The document appears to be a master list containing information about women of reproductive age and adolescent women for family planning services. It includes columns for name, address, age, birthdate, civil status, fertility status, current and desired family planning methods. The list seems to be used to track women and provide family planning services and determine unmet need. It contains identifying information and asks personal questions about reproduction that could be sensitive.

Uploaded by

Han Nah Ju Deah
Copyright
© © All Rights Reserved
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
454 views

Unmet Form

The document appears to be a master list containing information about women of reproductive age and adolescent women for family planning services. It includes columns for name, address, age, birthdate, civil status, fertility status, current and desired family planning methods. The list seems to be used to track women and provide family planning services and determine unmet need. It contains identifying information and asks personal questions about reproduction that could be sensitive.

Uploaded by

Han Nah Ju Deah
Copyright
© © All Rights Reserved
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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Master List of Women of Reproduted Age and Adolescent Women for Family Planning Services (1/2) Master List

Master List of Woman of Reproductive Age and Adolescent Women for Family Planning Services (2/2)
No. H.H Name of WRA Address Age in Years Birthday SE Civil Status Do you plan to No. Facundity (Place If col. 8b & 8c is √, are you currently using If col 8b. Or 8c is √ Does this Based on TLC on FP , did WRA accept
No. (MM/DD/YY) Status have more a √) any FP method? and using col. 10b or WRA has any modern FP method?
(1) children? (Place a √) 10c, would you like MFP Unmet
to shift to Modern Need?
method? (Place a √)

10 to 14 15-19 20-49 1:NHTS (1) Currently If Yes, when? No Fecund Infecund If Yes. What type? Not using any Yes (11a) No (11b) Place a No. Yes
2: Non- Married (2) Not (9a) (9b)
married but in a FP Method √- if Yes (13a) (13b)
NHTS relationship as if (Place a √) X- if (Put a √_
married/ Living-in now Spacing Limiting Modern Traditional No Specify Date when
(3) Not married (8a) (8b) (8c)
and not in any (10a) (10b) modern FP FP method
relation with a man Method accepted

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