Name of Head TOILET OWNERSHIP

Privately- Shared Toilet No Toilet Flush Type

TOILET TYPE
Pour Flush Pit Latrine
of Household Owned (If yes, skip Type (Deretso sa
Toilet toilet type) (De Tabo) Bangag)

Name of Barangay: ____________________ Purok No. : __________

Name of Head TOILET OWNERSHIP
Privately- Shared Toilet No Toilet Flush Type
TOILET TYPE
Pour Flush Pit Latrine
of Household Owned (If yes, skip Type (Deretso sa
Toilet toilet type) (De Tabo) Bangag)