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Stillbirth Reduction (Baseline Survey)PID 17
My Projects Project Home Project Setup Online Designer Data Dictionary Codebook

The Codebook is a human-readable, read-only version of the project's Data Dictionary and serves as a quick reference for viewing the attributes of any given field in the project without having to download and interpret the Data Dictionary. Note: Checkbox fields have their coded values displayed both in the format defined by users in the Online Designer/Data Dictionary as well as in the extended format seen in data imports and exports (i.e., field___code).

Data Dictionary Codebook 07/04/2025 10:28pm
Field finder: — When viewing this page, collapse:
Data Dictionary Codebook
Stillbirth Reduction (Baseline Survey) (PID: 17)
07/04/2025 10:28pm
Instruments
Instrument Form Name
Form 1 form_1
# Variable / Field Name Field Label
Field Note
 Field Attributes (Field Type, Validation, Choices, Calculations, etc.)
Instrument:Form 1(form_1)
1 [record_id] Record ID text
2 [field_officer_name] Field officer name text
Field Annotation: @HIDEBUTTON @APPUSERNAME-APP
3 [section_1_icmr_still_birth] SECTION 1: ICMR - STILL BIRTH REDUCTION descriptive
4 [date_of_interview] Date of Interview text (datetime_seconds_dmy), Required
Field Annotation: @NOW-SERVER
5 [field_investigator_code] Field Investigator code text, Required
6 [block] Block radio, Required
1Urban
2Rural
7 [taluk_name] Taluk Name text, Required
8 [rural_village_name_or_loc]
Show the field ONLY if:
[block] = '2'
If Rural, Village name (or Locality name) text, Required
9 [if_urban]
Show the field ONLY if:
[block] = '1'
If Urban, radio, Required
1City
2Town
10 [household_id_where_survey] Household ID (where survey is done) text, Required
11 [number_of_pregnant_women_last_year] Number of Pregnant women in the last one year [1st Jan 2023 to 31st Aug 2024] radio, Required
00
11
22
33
44
12 [num_of_pregnancies_in_wom1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Number of pregnancies in pregnant women 1 text (number)
13 [num_of_pregnancies_in_wom2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Number of pregnancies in pregnant women 1 text (number)
14 [num_of_pregnancies_in_wom2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Number of pregnancies in pregnant women 2 text (number)
15 [num_of_pregnancies_in_wom3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Number of pregnancies in pregnant women 1 text (number)
16 [num_of_pregnancies_in_wom3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Number of pregnancies in pregnant women 2 text (number)
17 [num_of_pregnancies_in_wom3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Number of pregnancies in pregnant women 3 text (number)
18 [num_of_pregnancies_in_wom4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Number of pregnancies in pregnant women 1 text (number)
19 [num_of_pregnancies_in_wom4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Number of pregnancies in pregnant women 2 text (number)
20 [num_of_pregnancies_in_wom4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Number of pregnancies in pregnant women 3 text (number)
21 [num_of_pregnancies_in_wom4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Number of pregnancies in pregnant women 4 text (number)
22 [household_address] Household Address text, Required
23 [pin_code] Pin code text (number), Required
24 [informant_name] Informant name text, Required
25 [informant_mobile_no] Informant Mobile No text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @PLACEHOLDER='10 Digits Number' @FORCE-MINMAX
26 [result_please_tick] Result: (Please tick)
 radio
1Eligible and consented. (Please fill in Q 14 onwards) Household (HH) is eligible with at least 1 pregnant woman in the last 1 year and consented to take part in the study.
2Eligible and not consented. (Please stop the survey) Eligible and not consented - HH is eligible with at least 1 pregnant woman in the last 1 year and but did not consent to take part in the study even after explaining the details of the study.
3Not eligible. (Please stop the survey) HH did not have any pregnancy woman in the last 1 year, hence not eligible.
27 [section_2_please_check_tha]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
SECTION 2: [Please check hospital record to confirm the data details] descriptive
28 [household_id_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Household ID text, Required
29 [mcp_card_number_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
MCP Card number text, Required
30 [mother_id_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Mother ID text, Required
31 [pregnancy_id_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Pregnancy ID text, Required
32 [baby_id_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Baby ID text, Required
33 [name_of_the_pregnant_women_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Name of the pregnant women text, Required
34 [age_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Current age of the pregnant women text (number), Required
35 [husband_s_name_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Husband's name text, Required
36 [number_of_pregnant_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Mobile number of pregnant women text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX
37 [number_of_husband]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Mobile number of husband text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX
38 [pregnant_woman_s_house]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Is this pregnant woman's mother house or
husband house. 		radio, Required
1Mother house
2Husband house
39 [pregnant_woman_usual_resident]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Is this the pregnant woman's usual resident? yesno, Required
1Yes
0No
40 [household_address_of_pregnant_women]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Household address of the pregnant women text
41 [pincod_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Pincode text (number)
42 [household_address_of_the_husband]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Household address of the husband text
43 [husband_add_pincod_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Pincode text (number)
44 [informant_relation]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Informant relation with pregnant woman text, Required
45 [lmp]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
LMP text (date_dmy), Required
46 [edd]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
EDD text (date_dmy), Required
47 [date_of_delivery]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Date of Delivery text (date_dmy), Required
48 [gestational_age_at_deliver]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Gestational Age at delivery (MCP - CARD) text (number), Required
49 [outcome_of_pregnancy]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
What was the outcome of the pregnancy? radio, Required
1Live birth
2Abortion
3Still birth
50 [how_is_the_baby_now]
Show the field ONLY if:
[outcome_of_pregnancy] = '1'
How is the baby now? radio, Required
1Live
2Dead
51 [mention_date_of_death]
Show the field ONLY if:
[how_is_the_baby_now] = '2'
Please mention date of death

 text (date_dmy), Required
52 [baby_stop_moving_womb]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Did the baby stop "moving" in the womb before labor pain started yesno, Required
1Yes
0No
53 [baby_show_any_sign]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Did the baby show any sign of life (cry or move) after delivery? yesno, Required
1Yes
0No
54 [weight_of_newborn]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '1'
Birth Weight of newborn (in gms) text (number), Required
55 [verbal_autopsy]
Show the field ONLY if:
[how_is_the_baby_now] = '2'
For Verbal autopsy interview
notes
56 [check_with_informant_regarding_time_date]
Show the field ONLY if:
[how_is_the_baby_now] = '2'
Please check with the informant regarding the preferred time for the verbal autopsy interview with the
mother/ care giver who was present at the time of delivery. 		descriptive
57 [autopsy_preferred_date]
Show the field ONLY if:
[how_is_the_baby_now] = '2'
Preferred Date text (date_dmy)
58 [autopsy_preferred_time]
Show the field ONLY if:
[how_is_the_baby_now] = '2'
Preferred Time text (time)
59 [please_check_tha_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
SECTION 2: [Please check hospital record to confirm the data details] descriptive
60 [household_id_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Household ID
(of the pregnant women 1) 		text, Required
61 [mcp_card_number_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
MCP Card number
(of the pregnant women 1) 		text, Required
62 [mother_id_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Mother ID
(of the pregnant women 1) 		text, Required
63 [pregnancy_id_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Pregnancy ID of women

(of the pregnant women 1) 		text, Required
64 [baby_id_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Baby ID

(of the pregnant women 1) 		text, Required
65 [name_of_the_pregnant_women_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Name of the pregnant women

(of the pregnant women 1) 		text, Required
66 [age_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Current age

(of the pregnant women 1) 		text (number), Required
67 [husband_s_name_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Husband's name

(of pregnant women 1) 		text, Required
68 [number_of_pregnant_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Mobile number

(of pregnant women 1) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX @PLACEHOLDER='10 digits'
69 [number_of_husband_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Mobile number of husband

(of pregnant women 1) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX @PLACEHOLDER='10 digits'
70 [pregnant_woman_s_house_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Is this pregnant woman's mother house or husband house

(of pregnant women 1) 		radio, Required
1Mother house
2Husband house
71 [pregnant_woman_usual_resident_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Is this the pregnant woman's usual resident

(of pregnant women 1) 		yesno, Required
1Yes
0No
72 [household_address_of_pregnant_women_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Household address

(of the pregnant women 1) 		text
73 [pincod_2_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Pincod text
74 [household_address_of_the_husband_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Household address of the husband

(of pregnant women 1) 		text
75 [husband_pin_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Pincode text
76 [informant_relation_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Informant relation with pregnant woman

(Of the pregnant women 1) 		text, Required
77 [lmp_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
LMP

(Of the pregnant women 1) 		text (date_dmy), Required
78 [edd_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
EDD

(Of the pregnant women 1) 		text (date_dmy), Required
79 [date_of_delivery_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Date of Delivery

(Of the pregnant women 1) 		text (date_dmy), Required
80 [gestational_age_at_deliver_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Gestational Age at delivery (MCP - CARD)
(of the pregnant women 1) 		text (number), Required
81 [outcome_of_pregnancy_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
What was the outcome of the pregnancy?
(of the pregnant women 1) 		radio, Required
1Live birth
2Abortion
3Still birth
82 [how_is_the_baby_now_2_1]
Show the field ONLY if:
[outcome_of_pregnancy_2_1] = '1'
How is the baby now?

(of the pregnant women 1) 		radio, Required
1Live
2Dead
83 [mention_date_of_death_2_1]
Show the field ONLY if:
[how_is_the_baby_now_2_1] = '2'
Please mention date of death

(of the pregnant women 1) 		text (date_dmy), Required
84 [baby_stop_moving_womb_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Did the baby stop "moving" in the womb before labor pain started
(of the pregnant women 1) 		yesno, Required
1Yes
0No
85 [baby_show_any_sign_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Did the baby show any sign of life (cry or move) after delivery?

(of the pregnant women 1) 		yesno, Required
1Yes
0No
86 [weight_of_newborn_2_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Birth Weight of newborn (in gms)

(of the pregnant women 1) 		text (number), Required
87 [verbal_autopsy_2_1]
Show the field ONLY if:
[how_is_the_baby_now_2_1] = '2'
For Verbal autopsy interview
notes
88 [check_with_informant_regarding_time_date_2_1]
Show the field ONLY if:
[how_is_the_baby_now_2_1] = '2'
Please check with the informant regarding the preferred time for the verbal autopsy interview with the
mother/ care giver who was present at the time of delivery. 		descriptive
89 [autopsy_preferred_date_2_1]
Show the field ONLY if:
[how_is_the_baby_now_2_1] = '2'
Preferred Date text (date_dmy)
90 [autopsy_preferred_time_2_1]
Show the field ONLY if:
[how_is_the_baby_now] = '2'
Preferred Time text (time)
91 [please_check_tha_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
SECTION 2: [Please check hospital record to confirm the data details] descriptive
92 [household_id_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Household ID
(of the pregnant women 2) 		text, Required
93 [mcp_card_number_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
MCP Card number 2

(of the pregnant women 2) 		text, Required
94 [mother_id_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Mother ID

(of the pregnant women 2) 		text, Required
95 [pregnancy_id_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Pregnancy ID of women

(of the pregnant women 2) 		text, Required
96 [baby_id_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Baby ID

(of the pregnant women 2) 		text, Required
97 [name_of_the_pregnant_women_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Name of the pregnant women

(of the pregnant women 2) 		text, Required
98 [age_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Current age

(of the pregnant women 2) 		text (number), Required
99 [husband_s_name_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Husband's name

(of pregnant women 2) 		text, Required
100 [number_of_pregnant_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Mobile number

(of pregnant women 2) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX @PLACEHOLDER='10 digits'
101 [number_of_husband_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Mobile number of husband

(of pregnant women 2) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX @PLACEHOLDER='10 digits'
102 [pregnant_woman_s_house_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Is this pregnant woman's mother house or
husband house of pregnant women 2 		radio, Required
1Mother house
2Husband house
103 [pregnant_woman_usual_resident_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Is this the pregnant woman's usual resident

(of pregnant women 2) 		yesno, Required
1Yes
0No
104 [household_address_of_the_pregnant_women_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Household address

(of the pregnant women 2) 		text
105 [pgwmn_pincod_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Pincode text
106 [household_address_of_the_husband_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Household address of the husband

(of pregnant women 2) 		text
107 [husband_pin_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Pincode text
108 [informant_relation_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Informant relation with pregnant woman

(Of the pregnant women 2) 		text, Required
109 [lmp_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
LMP

(Of the pregnant women 2) 		text (date_dmy), Required
110 [edd_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
EDD

(Of the pregnant women 2) 		text (date_dmy), Required
111 [date_of_delivery_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Date of Delivery

(of the pregnant women 2) 		text (date_dmy), Required
112 [gestational_age_at_deliver_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Gestational Age at delivery (MCP - CARD)
(of the pregnant women 2) 		text (number), Required
113 [outcome_of_pregnancy_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
What was the outcome of the pregnancy?
(of the pregnant women 2) 		radio, Required
1Live birth
2Abortion
3Still birth
114 [how_is_the_baby_now_2_2]
Show the field ONLY if:
[outcome_of_pregnancy_2_2] = '1'
How is the baby now?

(of the pregnant women 2) 		radio, Required
1Live
2Dead
115 [mention_date_of_death_2_2]
Show the field ONLY if:
[how_is_the_baby_now_2_2] = '2'
Please mention date of death

(of the pregnant women 2) 		text (date_dmy), Required
116 [baby_stop_moving_womb_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Did the baby stop "moving" in the womb before labor pain started
(of the pregnant women 2) 		yesno, Required
1Yes
0No
117 [baby_show_any_sign_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Did the baby show any sign of life (cry or move) after delivery?

(of the pregnant women 2) 		yesno, Required
1Yes
0No
118 [weight_of_newborn_2_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '2'
Birth Weight of newborn (in gms)

(of the pregnant women 2) 		text (number), Required
119 [verbal_autopsy_2_2]
Show the field ONLY if:
[how_is_the_baby_now_2_2] = '2'
For Verbal autopsy interview
notes
120 [check_with_informant_regarding_time_date_2_2]
Show the field ONLY if:
[how_is_the_baby_now_2_2] = '2'
Please check with the informant regarding the preferred time for the verbal autopsy interview with the
mother/ care giver who was present at the time of delivery. 		descriptive
121 [autopsy_preferred_date_2_2]
Show the field ONLY if:
[how_is_the_baby_now_2_2] = '2'
Preferred Date text (date_dmy)
122 [autopsy_preferred_time_2_2]
Show the field ONLY if:
[how_is_the_baby_now_2_2] = '2'
Preferred Time text (time)
123 [section_2_please_check_tha_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
SECTION 2: [Please check hospital record to confirm the data details] descriptive
124 [household_id_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Household ID
(Of the pregnant women 1) 		text, Required
125 [mcp_card_number_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
MCP Card number
(Of the pregnant women 1) 		text, Required
126 [mother_id_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Mother ID
(Of the pregnant women 1) 		text, Required
127 [pregnancy_id_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Pregnancy ID

(Of the pregnant women 1) 		text, Required
128 [baby_id_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Baby ID

(Of the pregnant women 1) 		text, Required
129 [name_of_the_pregnant_women_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Name of the pregnant women

(Of the pregnant women 1) 		text, Required
130 [age_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Current age of the pregnant women

(of the pregnant women 1) 		text (number), Required
131 [husband_s_name_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Husband's name

(Of the pregnant women 1) 		text, Required
132 [number_of_pregnant_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Mobile number of pregnant women

(Of the pregnant women 1) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX
133 [number_of_husband_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Mobile number of husband

(Of the pregnant women 1) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX
134 [pregnant_woman_s_house_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Is this pregnant woman's mother house or husband house.

(Of the pregnant women 1) 		radio, Required
1Mother house
2Husband house
135 [pregnant_woman_usual_resident_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Is this the pregnant woman's usual resident?

(Of the pregnant women 1) 		yesno, Required
1Yes
0No
136 [household_address_of_pregnant_women_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Household address

(of the pregnant women 1) 		text
137 [pincod_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Pincode text (number)
138 [house_add_of_husband_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Household address of the husband

(Of the pregnant women 1) 		text
139 [husband_add_pincod_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Pincode text (number)
140 [informant_relation_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Informant relation with pregnant woman

(Of the pregnant women 1) 		text, Required
141 [lmp_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
LMP

(Of the pregnant women 1) 		text (date_dmy), Required
142 [edd_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
EDD

(Of the pregnant women 1) 		text (date_dmy), Required
143 [date_of_delivery_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Date of Delivery

(Of the pregnant women 1) 		text (date_dmy), Required
144 [gestational_age_deliver_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Gestational Age at delivery (MCP - CARD)

(Of the pregnant women 1) 		text (number), Required
145 [outcome_of_pregnancy_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
What was the outcome of the pregnancy?

(Of the pregnant women 1) 		radio, Required
1Live birth
2Abortion
3Still birth
146 [how_is_the_baby_now_3_1]
Show the field ONLY if:
[outcome_of_pregnancy_3_1] = '1'
How is the baby now?

(Of the pregnant women 1) 		radio, Required
1Live
2Dead
147 [mention_date_of_death_3_1]
Show the field ONLY if:
[how_is_the_baby_now_3_1] = '2'
Please mention date of death

(Of the pregnant women 1)

 text (date_dmy), Required
148 [baby_stop_moving_womb_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Did the baby stop "moving" in the womb before labor pain started

(Of the pregnant women 1) 		yesno, Required
1Yes
0No
149 [baby_show_any_sign_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Did the baby show any sign of life (cry or move) after delivery?

(Of the pregnant women 1) 		yesno, Required
1Yes
0No
150 [weight_of_newborn_3_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Birth Weight of newborn (in gms)

(Of the pregnant women 1) 		text (number), Required
151 [verbal_autopsy_3_1]
Show the field ONLY if:
[how_is_the_baby_now_3_1] = '2'
For Verbal autopsy interview

(Of the pregnant women 1) 		notes
152 [check_with_informant_regarding_time_date_3_1]
Show the field ONLY if:
[how_is_the_baby_now_3_1] = '2'
Please check with the informant regarding the preferred time for the verbal autopsy interview with the
mother/ care giver who was present at the time of delivery.

(Of the pregnant women 1) 		descriptive
153 [autopsy_preferred_date_3_1]
Show the field ONLY if:
[how_is_the_baby_now_3_1] = '2'
Preferred Date

(Of the pregnant women 1) 		text (date_dmy)
154 [autopsy_preferred_time_3_1]
Show the field ONLY if:
[how_is_the_baby_now_3_1] = '2'
Preferred Time

(Of the pregnant women 1) 		text (time)
155 [section_2_please_check_tha_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
SECTION 2: [Please check hospital record to confirm the data details] descriptive
156 [household_id_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Household ID
(Of the pregnant women 2) 		text, Required
157 [mcp_card_number_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
MCP Card number
(Of the pregnant women 2) 		text, Required
158 [mother_id_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Mother ID
(Of the pregnant women 2) 		text, Required
159 [pregnancy_id_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Pregnancy ID

(Of the pregnant women 2) 		text, Required
160 [baby_id_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Baby ID

(Of the pregnant women 2) 		text, Required
161 [name_of_the_pregnant_women_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Name of the pregnant women

(Of the pregnant women 2) 		text, Required
162 [age_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Current age of the pregnant women

(of the pregnant women 2) 		text (number), Required
163 [husband_s_name_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Husband's name

(Of the pregnant women 2) 		text, Required
164 [number_of_pregnant_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Mobile number of pregnant women

(Of the pregnant women 2) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX
165 [number_of_husband_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Mobile number of husband

(Of the pregnant women 2) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX
166 [pregnant_woman_s_house_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Is this pregnant woman's mother house or husband house.

(Of the pregnant women 2) 		radio, Required
1Mother house
2Husband house
167 [pregnant_woman_usual_resident_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Is this the pregnant woman's usual resident?

(Of the pregnant women 2) 		yesno, Required
1Yes
0No
168 [household_address_of_pregnant_women_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Household address

(of the pregnant women 2) 		text
169 [pincod_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Pincode text (number)
170 [house_add_of_husband_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Household address of the husband

(Of the pregnant women 2) 		text
171 [husband_add_pincod_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Pincode text (number)
172 [informant_relation_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Informant relation with pregnant woman

(Of the pregnant women 2) 		text, Required
173 [lmp_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
LMP

(Of the pregnant women 2) 		text (date_dmy), Required
174 [edd_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
EDD

(Of the pregnant women 2) 		text (date_dmy), Required
175 [date_of_delivery_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Date of Delivery

(Of the pregnant women 2) 		text (date_dmy), Required
176 [gestational_age_deliver_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Gestational Age at delivery (MCP - CARD)

(Of the pregnant women 2) 		text (number), Required
177 [outcome_of_pregnancy_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
What was the outcome of the pregnancy?

(Of the pregnant women 2) 		radio, Required
1Live birth
2Abortion
3Still birth
178 [how_is_the_baby_now_3_2]
Show the field ONLY if:
[outcome_of_pregnancy_3_2] = '1'
How is the baby now?

(Of the pregnant women 2) 		radio, Required
1Live
2Dead
179 [mention_date_of_death_3_2]
Show the field ONLY if:
[how_is_the_baby_now_3_2] = '2'
Please mention date of death

(Of the pregnant women 2)

 text (date_dmy), Required
180 [baby_stop_moving_womb_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Did the baby stop "moving" in the womb before labor pain started

(Of the pregnant women 2) 		yesno, Required
1Yes
0No
181 [baby_show_any_sign_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Did the baby show any sign of life (cry or move) after delivery?

(Of the pregnant women 2) 		yesno, Required
1Yes
0No
182 [weight_of_newborn_3_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Birth Weight of newborn (in gms)

(Of the pregnant women 2) 		text (number), Required
183 [verbal_autopsy_3_2]
Show the field ONLY if:
[how_is_the_baby_now_3_2] = '2'
For Verbal autopsy interview

(Of the pregnant women 2) 		notes
184 [check_with_informant_regarding_time_date_3_2]
Show the field ONLY if:
[how_is_the_baby_now_3_2] = '2'
Please check with the informant regarding the preferred time for the verbal autopsy interview with the
mother/ care giver who was present at the time of delivery.

(Of the pregnant women 2) 		descriptive
185 [autopsy_preferred_date_3_2]
Show the field ONLY if:
[how_is_the_baby_now_3_2] = '2'
Preferred Date

(Of the pregnant women 2) 		text (date_dmy)
186 [autopsy_preferred_time_3_2]
Show the field ONLY if:
[how_is_the_baby_now_3_2] = '2'
Preferred Time

(Of the pregnant women 2) 		text (time)
187 [section_2_please_check_tha_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
SECTION 2: [Please check hospital record to confirm the data details] descriptive
188 [household_id_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Household ID
(Of the pregnant women 3) 		text, Required
189 [mcp_card_number_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
MCP Card number
(Of the pregnant women 3) 		text, Required
190 [mother_id_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Mother ID
(Of the pregnant women 3) 		text, Required
191 [pregnancy_id_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Pregnancy ID

(Of the pregnant women 3) 		text, Required
192 [baby_id_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Baby ID

(Of the pregnant women 3) 		text, Required
193 [name_of_the_pregnant_women_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Name of the pregnant women

(Of the pregnant women 3) 		text, Required
194 [age_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Current age of the pregnant women

(of the pregnant women 3) 		text (number), Required
195 [husband_s_name_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Husband's name

(Of the pregnant women 3) 		text, Required
196 [number_of_pregnant_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Mobile number of pregnant women

(Of the pregnant women 3) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX
197 [number_of_husband_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Mobile number of husband

(Of the pregnant women 3) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX
198 [pregnant_woman_s_house_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Is this pregnant woman's mother house or husband house.

(Of the pregnant women 3) 		radio, Required
1Mother house
2Husband house
199 [pregnant_woman_usual_resident_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Is this the pregnant woman's usual resident?

(Of the pregnant women 3) 		yesno, Required
1Yes
0No
200 [household_address_of_pregnant_women_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Household address

(of the pregnant women 3) 		text
201 [pincod_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Pincode text (number)
202 [house_add_of_husband_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Household address of the husband

(Of the pregnant women 3) 		text
203 [husband_add_pincod_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Pincode text (number)
204 [informant_relation_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Informant relation with pregnant woman

(Of the pregnant women 3) 		text, Required
205 [lmp_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
LMP

(Of the pregnant women 3) 		text (date_dmy), Required
206 [edd_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
EDD

(Of the pregnant women 3) 		text (date_dmy), Required
207 [date_of_delivery_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Date of Delivery

(Of the pregnant women 3) 		text (date_dmy), Required
208 [gestational_age_deliver_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Gestational Age at delivery (MCP - CARD)

(Of the pregnant women 3) 		text (number), Required
209 [outcome_of_pregnancy_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
What was the outcome of the pregnancy?

(Of the pregnant women 3) 		radio, Required
1Live birth
2Abortion
3Still birth
210 [how_is_the_baby_now_3_3]
Show the field ONLY if:
[outcome_of_pregnancy_3_3] = '1'
How is the baby now?

(Of the pregnant women 3) 		radio, Required
1Live
2Dead
211 [mention_date_of_death_3_3]
Show the field ONLY if:
[how_is_the_baby_now_3_3] = '2'
Please mention date of death

(Of the pregnant women 3)

 text (date_dmy), Required
212 [baby_stop_moving_womb_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Did the baby stop "moving" in the womb before labor pain started

(Of the pregnant women 3) 		yesno, Required
1Yes
0No
213 [baby_show_any_sign_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Did the baby show any sign of life (cry or move) after delivery?

(Of the pregnant women 3) 		yesno, Required
1Yes
0No
214 [weight_of_newborn_3_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '3'
Birth Weight of newborn (in gms)

(Of the pregnant women 3) 		text (number), Required
215 [verbal_autopsy_3_3]
Show the field ONLY if:
[how_is_the_baby_now_3_3] = '2'
For Verbal autopsy interview

(Of the pregnant women 3) 		notes
216 [check_with_informant_regarding_time_date_3_3]
Show the field ONLY if:
[how_is_the_baby_now_3_3] = '2'
Please check with the informant regarding the preferred time for the verbal autopsy interview with the
mother/ care giver who was present at the time of delivery.

(Of the pregnant women 3) 		descriptive
217 [autopsy_preferred_date_3_3]
Show the field ONLY if:
[how_is_the_baby_now_3_3] = '2'
Preferred Date

(Of the pregnant women 3) 		text (date_dmy)
218 [autopsy_preferred_time_3_3]
Show the field ONLY if:
[how_is_the_baby_now_3_3] = '2'
Preferred Time

(Of the pregnant women 3) 		text (time)
219 [section_2_please_check_tha_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
SECTION 2: [Please check hospital record to confirm the data details] descriptive
220 [household_id_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Household ID
(of the pregnant women 1) 		text, Required
221 [mcp_card_number_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
MCP Card number
(of the pregnant women 1) 		text, Required
222 [mother_id_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Mother ID
(of the pregnant women 1) 		text, Required
223 [pregnancy_id_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Pregnancy ID of women

(of the pregnant women 1) 		text, Required
224 [baby_id_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Baby ID

(of the pregnant women 1) 		text, Required
225 [name_of_the_pregnant_women_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Name of the pregnant women

(of the pregnant women 1) 		text, Required
226 [age_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Current age

(of the pregnant women 1) 		text (number), Required
227 [husband_s_name_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Husband's name

(of pregnant women 1) 		text, Required
228 [number_of_pregnant_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Mobile number

(of pregnant women 1) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX @PLACEHOLDER='10 digits'
229 [number_of_husband_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Mobile number of husband

(of pregnant women 1) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX @PLACEHOLDER='10 digits'
230 [pregnant_woman_s_house_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Is this pregnant woman's mother house or husband house

(of pregnant women 1) 		radio, Required
1Mother house
2Husband house
231 [pregnant_woman_usual_resident_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Is this the pregnant woman's usual resident

(of pregnant women 1) 		yesno, Required
1Yes
0No
232 [household_address_of_pregnant_women_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Household address

(of the pregnant women 1) 		text
233 [prgwmn_pin_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Pincode text
234 [household_address_of_the_husband_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Household address of the husband

(of pregnant women 1) 		text
235 [husband_pin_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Pincode text
236 [informant_relation_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Informant relation with pregnant woman

(Of the pregnant women 1) 		text, Required
237 [lmp_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
LMP

(Of the pregnant women 1) 		text (date_dmy), Required
238 [edd_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
EDD

(Of the pregnant women 1) 		text (date_dmy), Required
239 [gestational_age_at_deliver_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Gestational Age at delivery (MCP - CARD)
(of the pregnant women 1) 		text (number), Required
240 [date_of_delivery_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Date of Delivery

(Of the pregnant women 1) 		text (date_dmy), Required
241 [outcome_of_pregnancy_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
What was the outcome of the pregnancy?
(of the pregnant women 1) 		radio, Required
1Live birth
2Abortion
3Still birth
242 [how_is_the_baby_now_4_1]
Show the field ONLY if:
[outcome_of_pregnancy_4_1] = '1'
How is the baby now?

(of the pregnant women 1) 		radio, Required
1Live
2Dead
243 [mention_date_of_death_4_1]
Show the field ONLY if:
[how_is_the_baby_now_4_1] = '2'
Please mention date of death

(of the pregnant women 1) 		text (date_dmy), Required
244 [baby_stop_moving_womb_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Did the baby stop "moving" in the womb before labor pain started
(of the pregnant women 1) 		yesno, Required
1Yes
0No
245 [baby_show_any_sign_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Did the baby show any sign of life (cry or move) after delivery?

(of the pregnant women 1) 		yesno, Required
1Yes
0No
246 [weight_of_newborn_4_1]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Birth Weight of newborn (in gms)

(of the pregnant women 1) 		text (number), Required
247 [verbal_autopsy_4_1]
Show the field ONLY if:
[how_is_the_baby_now_4_1] = '2'
For Verbal autopsy interview

(Of the pregnant women 1) 		notes
248 [check_with_informant_regarding_time_date_4_1]
Show the field ONLY if:
[how_is_the_baby_now_4_1] = '2'
Please check with the informant regarding the preferred time for the verbal autopsy interview with the
mother/ care giver who was present at the time of delivery. 		descriptive
249 [autopsy_preferred_date_4_1]
Show the field ONLY if:
[how_is_the_baby_now_4_1] = '2'
Preferred Date text (date_dmy)
250 [autopsy_preferred_time_4_1]
Show the field ONLY if:
[how_is_the_baby_now_4_1] = '2'
Preferred Time text (time)
251 [section_2_please_check_tha_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
SECTION 2: [Please check hospital record to confirm the data details] descriptive
252 [household_id_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Household ID
(of the pregnant women 2) 		text, Required
253 [mcp_card_number_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
MCP Card number
(of the pregnant women 2) 		text, Required
254 [mother_id_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Mother ID
(of the pregnant women 2) 		text, Required
255 [pregnancy_id_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Pregnancy ID of women

(of the pregnant women 2) 		text, Required
256 [baby_id_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Baby ID

(of the pregnant women 2) 		text, Required
257 [name_of_the_pregnant_women_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Name of the pregnant women

(of the pregnant women 2) 		text, Required
258 [age_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Current age

(of the pregnant women 2) 		text (number), Required
259 [husband_s_name_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Husband's name

(of the pregnant women 2) 		text, Required
260 [number_of_pregnant_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Mobile number

(of the pregnant women 2) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX @PLACEHOLDER='10 digits'
261 [number_of_husband_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Mobile number of husband

(of the pregnant women 2) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX @PLACEHOLDER='10 digits'
262 [pregnant_woman_s_house_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Is this pregnant woman's mother house or husband house

(of the pregnant women 2) 		radio, Required
1Mother house
2Husband house
263 [pregnant_woman_usual_resident_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Is this the pregnant woman's usual resident

(of the pregnant women 2) 		yesno, Required
1Yes
0No
264 [household_address_of_pregnant_women_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Household address

(of the pregnant women 2) 		text
265 [prgwmn_pin_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Pincode text
266 [household_address_of_the_husband_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Household address of the husband

(of the pregnant women 2) 		text
267 [husband_pin_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Pincode text
268 [informant_relation_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Informant relation with pregnant woman

(Of the pregnant women 2) 		text, Required
269 [lmp_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
LMP

(Of the pregnant women 2) 		text (date_dmy), Required
270 [edd_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
EDD

(Of the pregnant women 2) 		text (date_dmy), Required
271 [gestational_age_at_deliver_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Gestational Age at delivery (MCP - CARD)
(Of the pregnant women 2) 		text (number), Required
272 [date_of_delivery_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Date of Delivery

(Of the pregnant women 2) 		text (date_dmy), Required
273 [outcome_of_pregnancy_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
What was the outcome of the pregnancy?
(Of the pregnant women 2) 		radio, Required
1Live birth
2Abortion
3Still birth
274 [how_is_the_baby_now_4_2]
Show the field ONLY if:
[outcome_of_pregnancy_4_2] = '1'
How is the baby now?

(Of the pregnant women 2) 		radio, Required
1Live
2Dead
275 [mention_date_of_death_4_2]
Show the field ONLY if:
[how_is_the_baby_now_4_2] = '2'
Please mention date of death

(Of the pregnant women 2) 		text (date_dmy), Required
276 [baby_stop_moving_womb_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Did the baby stop "moving" in the womb before labor pain started
(Of the pregnant women 2) 		yesno, Required
1Yes
0No
277 [baby_show_any_sign_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Did the baby show any sign of life (cry or move) after delivery?

(Of the pregnant women 2) 		yesno, Required
1Yes
0No
278 [weight_of_newborn_4_2]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Birth Weight of newborn (in gms)

(Of the pregnant women 2) 		text (number), Required
279 [verbal_autopsy_4_2]
Show the field ONLY if:
[how_is_the_baby_now_4_2] = '2'
For Verbal autopsy interview

(Of the pregnant women 2) 		notes
280 [check_with_informant_regarding_time_date_4_2]
Show the field ONLY if:
[how_is_the_baby_now_4_2] = '2'
Please check with the informant regarding the preferred time for the verbal autopsy interview with the
mother/ care giver who was present at the time of delivery. 		descriptive
281 [autopsy_preferred_date_4_2]
Show the field ONLY if:
[how_is_the_baby_now_4_2] = '2'
Preferred Date text (date_dmy)
282 [autopsy_preferred_time_4_2]
Show the field ONLY if:
[how_is_the_baby_now_4_2] = '2'
Preferred Time text (time)
283 [section_2_please_check_tha_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
SECTION 2: [Please check hospital record to confirm the data details] descriptive
284 [household_id_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Household ID
(of the pregnant women 3) 		text, Required
285 [mcp_card_number_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
MCP Card number
(of the pregnant women 3) 		text, Required
286 [mother_id_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Mother ID
(of the pregnant women 3) 		text, Required
287 [pregnancy_id_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Pregnancy ID of women

(of the pregnant women 3) 		text, Required
288 [baby_id_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Baby ID

(of the pregnant women 3) 		text, Required
289 [name_of_the_pregnant_women_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Name of the pregnant women

(of the pregnant women 3) 		text, Required
290 [age_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Current age

(of the pregnant women 3) 		text (number), Required
291 [husband_s_name_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Husband's name

(of the pregnant women 3) 		text, Required
292 [number_of_pregnant_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Mobile number

(of the pregnant women 3) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX @PLACEHOLDER='10 digits'
293 [number_of_husband_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Mobile number of husband

(of the pregnant women 3) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX @PLACEHOLDER='10 digits'
294 [pregnant_woman_s_house_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Is this pregnant woman's mother house or husband house

(of the pregnant women 3) 		radio, Required
1Mother house
2Husband house
295 [pregnant_woman_usual_resident_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Is this the pregnant woman's usual resident

(of the pregnant women 3) 		yesno, Required
1Yes
0No
296 [household_address_of_pregnant_women_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Household address

(of the pregnant women 3) 		text
297 [prgwmn_pin_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Pincode text
298 [household_address_of_the_husband_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Household address of the husband

(of the pregnant women 3) 		text
299 [husband_pin_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Pincode text
300 [informant_relation_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Informant relation with pregnant woman

(of the pregnant women 3) 		text, Required
301 [lmp_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
LMP

(of the pregnant women 3) 		text (date_dmy), Required
302 [edd_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
EDD

(of the pregnant women 3) 		text (date_dmy), Required
303 [gestational_age_at_deliver_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Gestational Age at delivery (MCP - CARD)
(of the pregnant women 3) 		text (number), Required
304 [date_of_delivery_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Date of Delivery

(of the pregnant women 3) 		text (date_dmy), Required
305 [outcome_of_pregnancy_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
What was the outcome of the pregnancy?
(of the pregnant women 3) 		radio, Required
1Live birth
2Abortion
3Still birth
306 [how_is_the_baby_now_4_3]
Show the field ONLY if:
[outcome_of_pregnancy_4_3] = '1'
How is the baby now?

(of the pregnant women 3) 		radio, Required
1Live
2Dead
307 [mention_date_of_death_4_3]
Show the field ONLY if:
[how_is_the_baby_now_4_3] = '2'
Please mention date of death

(of the pregnant women 3) 		text (date_dmy), Required
308 [baby_stop_moving_womb_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Did the baby stop "moving" in the womb before labor pain started
(of the pregnant women 3) 		yesno, Required
1Yes
0No
309 [baby_show_any_sign_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Did the baby show any sign of life (cry or move) after delivery?

(of the pregnant women 3) 		yesno, Required
1Yes
0No
310 [weight_of_newborn_4_3]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Birth Weight of newborn (in gms)

(of the pregnant women 3) 		text (number), Required
311 [verbal_autopsy_4_3]
Show the field ONLY if:
[how_is_the_baby_now_4_3] = '2'
For Verbal autopsy interview

(Of the pregnant women 2) 		notes
312 [check_with_informant_regarding_time_date_4_3]
Show the field ONLY if:
[how_is_the_baby_now_4_3] = '2'
Please check with the informant regarding the preferred time for the verbal autopsy interview with the
mother/ care giver who was present at the time of delivery. 		descriptive
313 [autopsy_preferred_date_4_3]
Show the field ONLY if:
[how_is_the_baby_now_4_3] = '2'
Preferred Date text (date_dmy)
314 [autopsy_preferred_time_4_3]
Show the field ONLY if:
[how_is_the_baby_now_4_3] = '2'
Preferred Time text (time)
315 [section_2_please_check_tha_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
SECTION 2: [Please check hospital record to confirm the data details] descriptive
316 [household_id_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Household ID
(of the pregnant women 4) 		text, Required
317 [mcp_card_number_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
MCP Card number
(of the pregnant women 4) 		text, Required
318 [mother_id_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Mother ID
(of the pregnant women 4) 		text, Required
319 [pregnancy_id_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Pregnancy ID of women

(of the pregnant women 4) 		text, Required
320 [baby_id_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Baby ID

(of the pregnant women 4) 		text, Required
321 [name_of_the_pregnant_women_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Name of the pregnant women

(of the pregnant women 4) 		text, Required
322 [age_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Current age

(of the pregnant women 4) 		text (number), Required
323 [husband_s_name_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Husband's name

(of the pregnant women 4) 		text, Required
324 [number_of_pregnant_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Mobile number

(of the pregnant women 4) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX @PLACEHOLDER='10 digits'
325 [number_of_husband_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Mobile number of husband

(of the pregnant women 4) 		text (number, Min: 0000000000, Max: 9999999999), Required
Field Annotation: @FORCE-MINMAX @PLACEHOLDER='10 digits'
326 [pregnant_woman_s_house_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Is this pregnant woman's mother house or husband house

(of the pregnant women 4) 		radio, Required
1Mother house
2Husband house
327 [pregnant_woman_usual_resident_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Is this the pregnant woman's usual resident

(of the pregnant women 4) 		yesno, Required
1Yes
0No
328 [household_address_of_pregnant_women_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Household address

(of the pregnant women 4) 		text
329 [prgwmn_pin_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Pincode text
330 [household_address_of_the_husband_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Household address of the husband

(of the pregnant women 4) 		text
331 [husband_pin_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Pincode text
332 [informant_relation_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Informant relation with pregnant woman

(of the pregnant women 4) 		text, Required
333 [lmp_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
LMP

(of the pregnant women 4) 		text (date_dmy), Required
334 [edd_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
EDD

(of the pregnant women 4) 		text (date_dmy), Required
335 [gestational_age_at_deliver_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Gestational Age at delivery (MCP - CARD)
(of the pregnant women 4) 		text (number), Required
336 [date_of_delivery_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Date of Delivery

(of the pregnant women 4) 		text (date_dmy), Required
337 [outcome_of_pregnancy_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
What was the outcome of the pregnancy?
(of the pregnant women 4) 		radio, Required
1Live birth
2Abortion
3Still birth
338 [how_is_the_baby_now_4_4]
Show the field ONLY if:
[outcome_of_pregnancy_4_4] = '1'
How is the baby now?

(of the pregnant women 4) 		radio, Required
1Live
2Dead
339 [mention_date_of_death_4_4]
Show the field ONLY if:
[how_is_the_baby_now_4_4] = '2'
Please mention date of death

(of the pregnant women 4) 		text (date_dmy), Required
340 [baby_stop_moving_womb_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Did the baby stop "moving" in the womb before labor pain started
(of the pregnant women 4) 		yesno, Required
1Yes
0No
341 [baby_show_any_sign_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Did the baby show any sign of life (cry or move) after delivery?

(of the pregnant women 4) 		yesno, Required
1Yes
0No
342 [weight_of_newborn_4_4]
Show the field ONLY if:
[number_of_pregnant_women_last_year] = '4'
Birth Weight of newborn (in gms)

(of the pregnant women 4) 		text (number), Required
343 [verbal_autopsy_4_4]
Show the field ONLY if:
[how_is_the_baby_now_4_4] = '2'
For Verbal autopsy interview

(of the pregnant women 4) 		notes
344 [check_with_informant_regarding_time_date_4_4]
Show the field ONLY if:
[how_is_the_baby_now_4_4] = '2'
Please check with the informant regarding the preferred time for the verbal autopsy interview with the
mother/ care giver who was present at the time of delivery. 		descriptive
345 [autopsy_preferred_date_4_4]
Show the field ONLY if:
[how_is_the_baby_now_4_4] = '2'
Preferred Date text (date_dmy)
346 [autopsy_preferred_time_4_4]
Show the field ONLY if:
[how_is_the_baby_now_4_4] = '2'
Preferred Time text (time)
347 [thank_you]
Show the field ONLY if:
[result_please_tick] = '2' OR [result_please_tick] = '3'
    Thank you! descriptive
348 [form_1_complete]
Section Header: Form Status
Complete? 		dropdown
0Incomplete
1Unverified
2Complete
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