An injection to prevent measles?
In the last 12 months did (NAME) receive a vitamin A capsule or supplement (like this)?
If YES: How many times did [NAME] received it?
When was the last time [NAME] was sick with fever, diarrhoea, or any other illness?
During [NAME]'s last episode of illness, did [NAME] have a fever (hot body)?
During [NAME]'s last episode of illness, did [NAME] have a cough?
During [NAME]'s last episode of illness, did [NAME] have difficulty or fast breathing?
During [NAME]'s last episode of illness, did [NAME] have diarrhea?
During [NAME]'s last episode of illness, did [NAME] have blood in their stools?
During [NAME]'s last episode of illness, did [NAME] have persistant vomiting?
During [NAME]'s last episode of illness, was [NAME] unable to eat/drink?
During [NAME]'s last episode of illness, did [NAME] have convulsions?
During [NAME]'s last episode of illness, did [NAME] have other symptoms?
During [NAME]'s last episode of illness, did [NAME] have other symptoms? Please specify.
During [NAME]'s last illness, was [NAME] given more than usual to drink, about the same amount, or less than usual to drink, including breastmilk?
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