Literal question
INTERVIEWER VISITS
FIRST VISIT:
DATE ___________
INTERVIEWER'S NAME ___________
RESULT ___________
NEXT VISIT:
DATE ___________
TIME ___________
SECOND VISIT:
DATE ___________
INTERVIEWER'S NAME ___________
RESULT ___________
NEXT VISIT:
DATE ___________
TIME ___________
THIRD VISIT:
DATE ___________
INTERVIEWER'S NAME ___________
RESULT ___________
FINAL VISIT:
DAY
MONTH
YEAR
NAME
RESULT
TOTAL NUMBER OF VISITS