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1) Gender
 
Male
 
Female
 
 
 
2) Age (in years)
 
18-24
 
25-44
 
45-64
 
65 and over
 
 
3) Ethnicity:
 
Indo-Mauritian
 
Creoles
 
Sino-Mauritian
 
Franco-Mauritian
 
 
 
4) Place of residence
 
Urban
 
Rural
 
 
 
5) Marital status:
 
Married
 
Single
 
Widow
 
Divorced
 
 
 
6) Educational level:
 
None
 
Primary
 
Secondary
 
Tertiary
 
 
 
7) Employment status:
 
Unemployed
 
Employed
 
Retired
 
 
 
8) Monthly income:
 
< 10000
 
10001 – 25000
 
25001 – 45000
 
45001 – 75000
 
75001 – 100000
 
> 100000
 
 
 
9) Health status
 
Poor
 
Fair
 
Good
 
Very good
 
Excellent
 
 
 
10) Disease episode(s) for which you take medication
   
 
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