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SpecifyOtherLast - If other, please specify

Monarch Enrolment Form

South Africa · 2015–2016 · MO-01.Monarch.Enrolment.Fom
DateLastAncVisit - What was the date of her last antenatal visit? (Approximately)

Monarch Enrolment Form

South Africa · 2015–2016 · MO-01.Monarch.Enrolment.Fom
GestageLastVisit - What was her gestational age when she had her last ANC visit? (Approximately)

Monarch Enrolment Form

South Africa · 2015–2016 · MO-01.Monarch.Enrolment.Fom
DeliveryPlaceEnrol - Place of Delivery

Monarch Enrolment Form

South Africa · 2015–2016 · MO-01.Monarch.Enrolment.Fom
SpecOtherPlaceofBirth - If Other, please specify

Monarch Enrolment Form

South Africa · 2015–2016 · MO-01.Monarch.Enrolment.Fom
DeliverOut - What was the outcome of the delivery?

Monarch Enrolment Form

South Africa · 2015–2016 · MO-01.Monarch.Enrolment.Fom
McrStill - If it was a stillbirth was the Maternity Case Record photographed for capturing?

Monarch Enrolment Form

South Africa · 2015–2016 · MO-01.Monarch.Enrolment.Fom
DateStillBirth - Is the date of stillbirth known?

Monarch Enrolment Form

South Africa · 2015–2016 · MO-01.Monarch.Enrolment.Fom
DateSpecific - What is the date of the stillbirth?

Monarch Enrolment Form

South Africa · 2015–2016 · MO-01.Monarch.Enrolment.Fom
Consent - Consent given for interview at Delivery:

Monarch Enrolment Form

South Africa · 2015–2016 · MO-01.Monarch.Enrolment.Fom
PlaceConsent1 - Place of consent for interview at Delivery

Monarch Enrolment Form

South Africa · 2015–2016 · MO-01.Monarch.Enrolment.Fom
Consent2 - Consent given for interview at 3-6 days Postnatal visit:

Monarch Enrolment Form

South Africa · 2015–2016 · MO-01.Monarch.Enrolment.Fom
ClrkConsent2 - Data clerk who obtain consent for interview at 3-6 days visit:

Monarch Enrolment Form

South Africa · 2015–2016 · MO-01.Monarch.Enrolment.Fom
PlaceConsent2 - Place of consent given for 3-6 days Postnatal interview

Monarch Enrolment Form

South Africa · 2015–2016 · MO-01.Monarch.Enrolment.Fom
Consent3 - Consent given for interview at 6 weeks Postnatal visit:

Monarch Enrolment Form

South Africa · 2015–2016 · MO-01.Monarch.Enrolment.Fom

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