Questionnaire Text

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P14. Disability / handicap
[] None
[] Spastic
[] Visually impaired
[] Leper
[] Mentally ill
[] Other disability

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P14) Disability / Handicap

Ask the following question: "Are you disabled? Do you have a handicap?"

If the answer is "No", circle: 1. None
If the answer is "Yes"; ask "What type of disability or handicap".
Circle:
2. "Spastic" for a disability of the limbs;
3. "Visually impaired" for the blind people;
4. "Leper" for the persons who have had or still have leprosy;
5. Mentally ill for the mentally retarded (insane, Down's syndrome, etc.)
6. Other disability for the other case not specified above.