Socio Economic and Demographic

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1. Gender

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2. Age (Required.)

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3. Status

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4. In which locality do you live

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5. How many persons live in your household? (Required.)

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6. How many members of your hosehold are adults (18 years or over)

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7. How many members of your household are under 18 years of age?

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8. How would you best describe your activity status

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12. Is the house you live in

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13. In which category would your house fall into

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