114

Blank No. 13 Series II Form B. 6

12 - What knowledge of sexual physiology had you before marriage?
b) how did you obtain it? Good deal. " Told by the Cob???]
I ever knew who had been married about 2 years."
13 - Number of times married. If more than once additional blanks
will be furnished you to answer the following questions separately
in regard to each marriage? once
14 - Number of years married? almost 7
15 - Do you habitualy sleep with your husband? b) what reasons
for so doing or not? a) no. not since first year
b) no because of children. the babies disturb the husbnd and he
can not sleep again.
16 - Number of conceptions? 2
17 - Number of children? State in connection with each a) date
of birth? b) sex? c) whether healthy or not? d) note any
characteristic and the cause. e) note either immediate
or after effect on your health of the birth of each of your
children. f) give time of first menstruation after birth
of each child.
(1) a) 10 June '87
10 June '87. 9 mo. & 8 days after marriage. b) boy c) very healthy, has had
congestion of lungs twice. e) came near having quick consumption, reduced from 125
to 90 lbs.
Dyspepsia after birth
& [??]
13 or 14 months, menstruated at once. [??] trouble with breasts.
2) 28 Apr 1892
b) boy c) very healthy d) --- e) severe labour, hemorrhage,

-213-