QUESTIONAIRE

The aim of this survey is to determine the storage pattern of reconstituted antibiotic suspension in the
Northern region and the possible effect of the observed storage attitude on the quality of drugs
PERSONAL INFORMATION
Location: .
Sex:

Male

Female

Educational status
Primary

Junior high school

Senior high School

Ter ary

None
Other (specify)
Occupation: .

Have you administered an antibiotic suspension before?

Yes

No

If yes please specify type ..

What condition did you use it for? .
Where did you store the suspension?
FRIDGE

CUPBOARD OR CLOSET

BEDROOM

BATHROOM

HANDBAG

TABLE TOP

KITCHEN
Others (specify)

Were there any changes in the suspension during usage (e.g. change in colour, taste, smell etc.)?

Was the condition relieved after usage of the suspension?

Yes

Thank you for taking the time to complete this survey.

No