Literal question
3.2 What type of disability or impairment does ____ have?
(More than one oval may be marked)
[Question 3.2 is asked of persons who have long-standing illness, disability or infirmity, per question 3.1]
[] Sight
[] Hearing
[] Speech
[] Upper limb (arm)
[] Lower limb (legs)
[] Neck and spine
[] Slowness at learning or understanding
[] Mental retardation
[] Other (please specify) ____