Questionnaire Text

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3.3 In which of the following ways are ____'s activities limited compared with most people your/his/her age?
(More than one oval may be marked)

[Question 3.3 is asked of persons who have long-standing illness, disability or infirmity, per question 3.1]

[] Self-care
[] Mobility
[] Communication
[] Schooling
[] Employment
[] Other
[] None