NONE A (GO TO 1101)
DIABETES B
HIGH BLOOD PRESSURE/STROKE C
CARDIAC ILLNESSES D
KIDNEY FAILURE E
CANCER F
PARALYSIS G
OTHER (SPECIFY) ______ X

BACK PAIN A
NECK OR SHOULDER PAIN B
HEADACHE, FACIAL OR DENTAL PAIN C
STOMACH ACHE OR ABDOMINAL PAIN D
PAIN IN ARMS, HANDS, HIPS, LEGS OR FEET E
CHEST PAIN F
OTHER (SPECIFY) __________ X