Literal question
<svar a="all" v="FR62A418 FR62A419 FR62A420"><span class="em">For all persons, regardless of age:</span><br /><br /><span class="h3">18a.</span> If you have an <span class="em">impairment or permanent physical disability</span>, please state it here:<br /><br /><div class="i1">____</div><br /><br />Examples: blind, almost blind, deaf-mute; characterized deafness [<span class="lang">surdite caracteriseee</span>]. For Amputation, maiming [<span class="lang">mutilation</span>], paralysis: please specify. For other impairment: please specify.<br /><br /><span class="h3">18b. Is it the result of:</span><br /><br /><div class="i1">[] 1 A war injury<br />[] 2 A work accident<br />[] 3 Other accident<br />[] 4 Illness or other reason</div><br /><br /><span class="h3">18c.</span> If necessary, indicate the corresponding percentage of disability: ____ %<br /></svar>