Response

Yes

No

1.Respiratory Tract Infection

(E.g. cough, cold, etc.)

1

2

2. Eye disease

1

2

3. Gastrointestinal disease

1

2

4. Sexually transmitted disease

1

2

5. Headache/Fever

1

2

6. Skin disease/Injury

1

2

7. Maternal/Menstrual

1

2

8. Others

1