Survey Text

1980
1979
top
1980
Survey form view entire document:  text  image
9a. Does anyone in the family use -
If "Yes," ask 9b and c

(1) Eyeglasses?
[] Y
[] N
(2) Contact lenses?
[] Y
[] N
(3) A hearing aid?
[] Y
[] N

b. Who is this? Mark box in person's column

1 [] Eyeglasses
2 [] Contact lenses
3 [] Hearing aid

c. Anyone else?


top
1979
Survey form view entire document:  text  image
9a. Does anyone in the family use -
If "Yes," ask 9b and c

(1) Eyeglasses?
[] Y
[] N
(2) Contact lenses?
[] Y
[] N
(3) A hearing aid?
[] Y
[] N

b. Who is this? Mark box in person's column

1 [] Eyeglasses
2 [] Contact lenses
3 [] Hearing aid

c. Anyone else?