Questionnaire Text

Questionnaire form view entire document:  text  image
6. What is (the person)?s race/origin?
[] Black
[] Mixed
[] White
[] Indian
[] Pakistani
[] Other
Questionnaire instructions view entire document:  text  image
P6. What is your race/origin?
Read the question and each answer choices (black, mixed, white, Indian, Pakistani or other). Mark X in the box the number corresponding to the response.