Questionnaire Text

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Chapter I. Disability information

36. Is there any person in this household who has a permanent physical or mental disability? ... Such as for example:

[] 1 Yes - Write on one line the name, surname, age, and disability (or disabilities) of the person, followed by the cause(s).
[] 6 No - Go on to Chapter J

Write down the impediment

List of possible impediments:

[] 1 Paralysis or diminished strength (kangy) of legs or arms
[] 2 Missing a part of the body
[] 3 Deaf (hears nothing)
[] 4 Does not hear well, needs or uses a hearing aid
[] 5 Mute (doesn't speak)
[] 6 Speaks with great difficulty
[] 7 Blind in both eyes (sees nothing)
[] 8 Blind in one eye
[] 9 Sees poorly, even with glasses
[] 10 Down syndrome (mongoloid)
[] 11 Mental retardation
[] 12 Crazy (dementia)
Questionnaire instructions view entire document:  text  image
I. Information about disabilities

Do not forget to ask this question.

Question 36: Is there a person in this household who has a permanent physical of mental disability?

Exclude the incapacities due to temporary problems, such as broken bones or illnesses.