[Questions 1 - 9 were asked of all individuals.]
Ask this question if, on the list of occupants of the dwelling (Chapter IV), the name of the person who has the circle number 1 marked (Yes) in question 4 (disability). In the case to the contrary, mark circle 8, None.
7. What type of physical or mental disability do you have?
[] 1 Blindness
[] 2 Deafness
[] 3 Mental retardation
[] 4 Cerebral paralysis
[] 5 Physical deficiency
[] 6 Mental problems
[] 7 Other (Specify)
[] 8 None.