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KH2019A_DISMOBIL
Having difficulty by walking or climbing step

Questionnaire Text

Questionnaire form view entire document:  text  image
Form B household questionnaire part 2

Individual particulars
[This section except for questions 6 and 8 are to be completed by all persons]

[Questions 17-22 of this section are to be answered by persons aged 5 years and older]

17. Functional difficulty

17.3 Do you have difficulty walking or climbing step?

[] 1. No -- no difficulty
[] 2. Yes -- some difficulty
[] 3. Yes -- a lot of difficulty
[] 4. Cannot do at all