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Blank No. 6 Series II. Form B. 7

18 - Did conception occur by choice or accident? --

19 - Habit of intercourse, average number of times per week? --
per month? Two or three times. per year?

20 - Was intercourse held during pregnancy? If so, how often?
b) had you any desire for it during this period? --

21 - At other times have you any desire for intercourse?
a) how often? b) at what time in relation to your menses
About two or three times a month, after menstruation and some
times before it.

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