Literal question
<span class="h1">Personal questionnaire</span></p>
<p>Were the name, address, date of birth and AHV number correct?</p>
<div class="i1">[] 1 Yes<br />[] 2 No (Please enter only the incorrect details):</div><div class="i2">First name: ____<br />Family name: ____<br />Street: ____<br />No.: _ _ _ _<br />PC: _ _ _ _<br />Town: ____<br />Date of birth: _ _. _ _. _ _ _ _ (dd.mm.yyyy)<br />AHV_Nr.: 756. _ _ _ _. _ _ _ _. _ _</div>