Questionnaire Text

Questionnaire form view entire document:  text  image
[Only on Form 1]
28a. Does this person have a health or physical condition which limits the kind or amount of work he can do at a job?

If 65 years old or over, skip to question 29.
[] Yes
[] No
"Health condition. This is a serious illness, or a serious handicap (impairment) affecting some part of the body or mind, which interferes with his ability to work at a job. Answer No for pregnancy, common colds, etc."