Questionnaire Text

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6. Shoes (Mark with an X)

This person by habit:

[ ] 7 Wears shoes
[ ] 8 Wears sandals
[ ] 9 Goes barefoot

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Footwear

Column 6

This involves finding out what the person wears on their feet the majority of the time. For all children less than one year old, the circle corresponding to "barefoot" should always be marked.