Domain C— Functional abilities — self caDomain C— Functional abilities — self care subdomain C (2)

Domain C— Functional abilities — self care subdomain C (2)

<table cellspacing="0" cellpadding="0" style="border-collapse:collapse"><thead><tr><td style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.03pt; vertical-align:top"><p class="TableColHead"><span>Question</span></p></td><td style="width:52.75pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableColHead"><span>Answer code</span></p></td><td style="width:52.2pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableColHead"><span>Raw value</span></p></td><td style="width:40.2pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableColHead"><span>Raw score</span></p></td><td colspan="2" style="width:67.65pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableColHead" style="text-align:center"><span>Score from age adjustment table</span></p></td><td style="width:60.75pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.4pt; vertical-align:top"><p class="TableColHead" style="text-align:center"><span>Age adjusted score</span></p></td></tr></thead><tbody><tr><td style="width:39.6pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>30</span></p></td><td style="width:52.15pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>a</span></p></td><td style="width:52.25pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>4</span></p></td><td style="width:40.15pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.2pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td colspan="2" style="width:61.2pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td></tr><tr><td style="width:39.6pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span></span></p></td><td style="width:52.15pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>b</span></p></td><td style="width:52.25pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>3</span></p></td><td style="width:40.15pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt"><p class="TableText"><span></span></p></td><td colspan="2" style="width:61.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt"><p class="TableText"><span></span></p></td></tr><tr><td style="width:39.6pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span></span></p></td><td style="width:52.15pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>c</span></p></td><td style="width:52.25pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>2</span></p></td><td style="width:40.15pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt"><p class="TableText"><span></span></p></td><td colspan="2" style="width:61.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt"><p class="TableText"><span></span></p></td></tr><tr><td style="width:39.6pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span></span></p></td><td style="width:52.15pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>d</span></p></td><td style="width:52.25pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>1</span></p></td><td style="width:40.15pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt"><p class="TableText"><span></span></p></td><td colspan="2" style="width:61.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt"><p class="TableText"><span></span></p></td></tr><tr><td style="width:39.6pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center; page-break-inside:avoid; page-break-after:avoid"><span>31</span></p></td><td style="width:52.15pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center; page-break-inside:avoid; page-break-after:avoid"><span>a</span></p></td><td style="width:52.25pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="page-break-inside:avoid; page-break-after:avoid"><span>4</span></p></td><td style="width:40.15pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="page-break-inside:avoid; page-break-after:avoid"><span></span></p></td><td style="width:67.2pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="page-break-inside:avoid; page-break-after:avoid"><span></span></p></td><td colspan="2" style="width:61.2pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="page-break-inside:avoid; page-break-after:avoid"><span></span></p></td></tr><tr><td style="width:39.6pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span></span></p></td><td style="width:52.15pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>b</span></p></td><td style="width:52.25pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>3</span></p></td><td style="width:40.15pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt"><p class="TableText"><span></span></p></td><td colspan="2" style="width:61.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt"><p class="TableText"><span></span></p></td></tr><tr><td style="width:39.6pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span></span></p></td><td style="width:52.15pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>c</span></p></td><td style="width:52.25pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>2</span></p></td><td style="width:40.15pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt"><p class="TableText"><span></span></p></td><td colspan="2" style="width:61.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt"><p class="TableText"><span></span></p></td></tr><tr><td style="width:39.6pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span></span></p></td><td style="width:52.15pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>d</span></p></td><td style="width:52.25pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>1</span></p></td><td style="width:40.15pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt"><p class="TableText"><span></span></p></td><td colspan="2" style="width:61.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt"><p class="TableText"><span></span></p></td></tr><tr style="height:0pt"><td style="width:50.4pt"></td><td style="width:63.55pt"></td><td style="width:63.05pt"></td><td style="width:51pt"></td><td style="width:78pt"></td><td style="width:0.45pt"></td><td style="width:71.55pt"></td></tr></tbody></table>