| What are the ages of other members of your household, if any? | ||
|---|---|---|
| # | Response Date | member 4 |
| 1. | ||
| 2. | ||
| 3. | ||
| 4. | ||
| 5. | 6/28/2008 7:34:00 PM | 21 |
| 6. | 6/30/2008 3:28:00 AM | 2 |
| 7. | ||
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| 18. | ||
| 19. | ||
| 20. | ||
| 21. | 7/7/2008 3:07:00 AM | 2 |
| 22. | ||
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| 33. | ||