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  1. Surveys
  2. 2016
  3. April
  4. C
  5. CHOLERA DISEASE
0%
Exit Survey
 
 
How old are you?( years)
 
below 18 (end questionnaire. Thank you)
 
18 and above(proceed to question 2)
 
 
 
What is you sex?
 
Male
 
Female
 
 
 
Have you ever heard about cholera?
 
Yes (proceed to question 4)
 
No (end questionnaire. Thank you)
 
 
 
Did you see a cholera patient?
 
Yes
 
No
 
 
 
What are the signs and symptoms of cholera?
   
 
 
 
Did you think peoples have enough knowledge about cholera?
 
Excellent
 
Very good
 
good
 
bad
 
satisfactory
 
 
 
Did central government take any measure about cholera?
 
yes
 
no
 
 
 
If answer in qn 7 is "Yes", what are those? (mention them)
   
 
 
 
What measures have you under taken to prevent cholera in your environment?
   
 
 
 
s there any person die because of outbreak of cholera in your environment ?
 
Yes
 
No