Interview questions (Anamneses of Post-Partum Mother)

Identity

1. Name  What is your name? I am….. or my name is….

 What is your husband name? My husband is… or my husband name is….

2. Age  How old are you? I am 17 years old, or 25 years old

 How old is your husband? He is 26 years old
3. Address  Where do you live? I live in garegeh.... I live at Melati street number.....
4. Religion What is your religion? I am....
5. Job  What is your job? I am teacher.
6. Phone number  What is your phone number?

Complaint

What do you feel? Or what are you feeling right now?

I feel……. I am feeling……

Giving Birth History

1. When did you give a birth? I gave a birth on March, 21

2. Where did you give a birth? I gave a birth in....
3. Who did help you? I helped by.....
4. Did you have secarian or normal one? I had....

Eating Pattern

1. How many times do you eat a day? Three times a day, 10 times a day, twice a day
2. How many glass do you drink a day? 8 glasses in day

Rest pattern

1. How long do you sleep at night? 8 hours at night.

2. How many hours do you take a nap in day? 30 minutes

Disease

a. Do you suffer from a disease right now?

b. What is your habit in your daily life? Are you smoking? Are you drinking alcohol? Are
drinking a cup coffee? Are you using a drug? Are you consuming herbal medicine?
c. Are you sometimes feeling sad? Are you feeling depressed? Are you feeling anxiety?