Survey Text

1976
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1976
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E
1 [] Under 6 (NP)
2 [] Eye condition in C2 (NP)
3 [] No eye condition in C2

2a. Can -- see well enough to read ordinary newspaper print WITH GLASSES with his:

left eye?
1 [] Y
2 [] N
right eye?
1 [] Y
2 [] N

If "N" for either eye, ask; otherwise go to NP.

b. What was the cause of --'s eye condition?

1 [] Acc./Inj.
2 [] Other