Appendix B
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- Words: 423
- Pages: 4
C 1
Respondent # ____
Gumagamit po ba kayo ng AMPALAYA?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
6
DOSE & DURATION OF USE
PREPARATION
INDICATION
7
8
Bakit po hindi kayo gumagamit ng AMPALAYA?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng AKAPULKO?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
6
DOSE & DURATION OF USE
PREPARATION
INDICATION
7
8
Bakit po hindi kayo gumagamit ng AKAPULKO?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng BAWANG?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
DOSE & DURATION OF USE
PREPARATION
6
11
7
8
Bakit po hindi kayo gumagamit ng BAWANG?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng BAYABAS?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
DOSE & DURATION OF USE
PREPARATION
6
INDICATION
7
8
Bakit po hindi kayo gumagamit ng BAYABAS?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng LAGUNDI? YES. Accomplish 2 6 to . 7
NO. Accomplish
2
3
4
PARTS USED PREPARATION
5
DOSE & DURATION OF USE
6
INDICATION
7
SOURCE
8
Bakit po hindi kayo gumagamit ng LAGUNDI?
NOTES
Respondent # ____ 1
Gumagamit po ba kayo ng NIYOG-NIYOGAN?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
6
DOSE & DURATION OF USE
PREPARATION
INDICATION
7
8
Bakit po hindi kayo gumagamit ng NIYOGNIYOGAN?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng SAMBONG?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
6
DOSE & DURATION OF USE
PREPARATION
INDICATION
7
8
Bakit po hindi kayo gumagamit ng SAMBONG?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng TSAANG GUBAT?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
DOSE & DURATION OF USE
PREPARATION
6
11
7
8
Bakit po hindi kayo gumagamit ng TSAANG GUBAT?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng ULASIMBANG BATO?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
DOSE & DURATION OF USE
PREPARATION
6
INDICATION
7
8
Bakit po hindi kayo gumagamit ng ULASIMBANG BATO?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng YERBA BUENA? YES. Accomplish 2 6 to . 7
NO. Accomplish
2
3
4
PARTS USED PREPARATION
5
DOSE & DURATION OF USE
6
INDICATION
7
SOURCE
8
Bakit po hindi kayo gumagamit ng YERBA BUENA?
NOTES
Respondent # ____
Gumagamit po ba kayo ng AMPALAYA?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
6
DOSE & DURATION OF USE
PREPARATION
INDICATION
7
8
Bakit po hindi kayo gumagamit ng AMPALAYA?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng AKAPULKO?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
6
DOSE & DURATION OF USE
PREPARATION
INDICATION
7
8
Bakit po hindi kayo gumagamit ng AKAPULKO?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng BAWANG?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
DOSE & DURATION OF USE
PREPARATION
6
11
7
8
Bakit po hindi kayo gumagamit ng BAWANG?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng BAYABAS?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
DOSE & DURATION OF USE
PREPARATION
6
INDICATION
7
8
Bakit po hindi kayo gumagamit ng BAYABAS?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng LAGUNDI? YES. Accomplish 2 6 to . 7
NO. Accomplish
2
3
4
PARTS USED PREPARATION
5
DOSE & DURATION OF USE
6
INDICATION
7
SOURCE
8
Bakit po hindi kayo gumagamit ng LAGUNDI?
NOTES
Respondent # ____ 1
Gumagamit po ba kayo ng NIYOG-NIYOGAN?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
6
DOSE & DURATION OF USE
PREPARATION
INDICATION
7
8
Bakit po hindi kayo gumagamit ng NIYOGNIYOGAN?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng SAMBONG?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
6
DOSE & DURATION OF USE
PREPARATION
INDICATION
7
8
Bakit po hindi kayo gumagamit ng SAMBONG?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng TSAANG GUBAT?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
DOSE & DURATION OF USE
PREPARATION
6
11
7
8
Bakit po hindi kayo gumagamit ng TSAANG GUBAT?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng ULASIMBANG BATO?
2
3
4
PARTS USED
YES. Accomplish 2 6 to .
5
DOSE & DURATION OF USE
PREPARATION
6
INDICATION
7
8
Bakit po hindi kayo gumagamit ng ULASIMBANG BATO?
SOURCE
NOTES
7
NO. Accomplish 1
Gumagamit po ba kayo ng YERBA BUENA? YES. Accomplish 2 6 to . 7
NO. Accomplish
2
3
4
PARTS USED PREPARATION
5
DOSE & DURATION OF USE
6
INDICATION
7
SOURCE
8
Bakit po hindi kayo gumagamit ng YERBA BUENA?
NOTES
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