295

Blank No.35 Series II Form B. 6.

12- What knowledge of sexual physiology had you before marriage?
(b) how did you obtain it? Slight from girls. Mother taught [her?] that such things were not only not talked about but also not thought of. School child at 14 told what intercourse was. was shocked and did not believe it.

13- Number of times married. Once. If more than once additional blanks will be furnished you to answer the following questions separately in regard to each marriage?
14- Number of years married? Since 69 = 28.5 yrs
15- Do you habitually sleep with your husband? (b)What reasons for doing or not? Yes until last 3 or 4 months. [This?] due to not sleeping [well?], [snoring?] etc, nervousness
16- Number of conceptions? 12
6 marriages and 6 children.

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.
1st miscarriage, [then?] girl [(a)?] 14 months after marriage. weight 10 lbs, very healthy. long labour. (e)good (f)15 months then weaned child child because of it. 2nd - boy 2.5 yrs later when he was 14 months old bit mother causing abcess and so weaned. He died of cholera infantum. [mo 92 yrs?] after weaning both child. Boy [(W)?] nursed 8 months, 10 lbs, very hearty (f)9 mo. not for 5 yrs. Husband ill with melancholia...great strain on her. then menstruated colorless [when?] to cold climate. [1st?] children ill with childrens diseases.