Depends on which country for example Italy the government pays for everyone’s doctors in their area they may go to a private doctor but will have to pay for it with their own money
The answer would be Traditional Economy. Hope this Helps!!
If this question has multiple answers, it'd be that the letter is dated and it is a handwritten document. If it's multiple choice. I'd say, logically, it'd be a handwritten document because anyone can put a date on a paper but it's very difficult to recreate someone's handwriting. Also, considering it was in 1854, they used feather pens and ink.
B and E. Their culture was changed sometimes involuntarily and They suffered a population decrease.
B. The British, French, and spanish all wanted new land