Questionnaire Text

Questionnaire form view entire document:  text  image

5.a. Marital status
[] 1 Single
[] 2 Married
[] 3 Widowed
[] 4 Divorced

Questionnaire instructions view entire document:  text  image

5a. Marital status:
[] 1 Single
[] 2 Married
[] 3 Widowed
[] 4 Divorced