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SRV Virginity Survey. Version 9.44.23-B
Name
(pseudonyms acceptable)

Sex M
F

Date of loss //

Duration of entire event (including undressing and dressing) hr min sec

Age, at the time

Sex of partner M
F

The sounds that were within earshot:
(select all that apply)
a dog barking
television
arguing
a party
birds
mosquitoes
sirens
other people losing their virginity
other please specify

Comments:



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