DVBCPYCK ;ALB/GTS-ALB/GTS-557/THM-PYELITIS, NEPHROLITHIASIS,ETC ; 2/6/91 7:56 AM ;;2.7;AMIE;;Apr 10, 1995 ; S PG=1,HD91="Department of Veterans Affairs",HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet" EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 0620 Worksheet" S HD6="PYELITIS, NEPHROLITHIASIS, URETEROLITHIASIS,",HD7="URETERAL STRICTURE AND HYDRONEPHROSIS (GU)",HD8="For "_HD6 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!,?(80-$L(HD7)\2),HD7,!! W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD6,!?14,HD7 W !!!!,"Narrative:" W ?13,"Complications and/or medical side effects should always be",!?13,"reported, even when not specifically requested.",!! I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",! D HD2 W $S($D(CMBN):"A. ",1:"D. "),"Specific evaluation information required by the rating board",!?4,"(if the information requested is included elsewhere, do not",!?4,"repeat here):",!!! W ?8,"1. Report presence or absence of calculi -",!!!!! W ?8,"2. If stone, presence and size if retained -",!!!!! W ?8,"3. Frequency of attacks of colic -",!!!!!?8,"4. Catheter drainage requirement (frequency of need) -",!!!!! W ?8,"5. Presence or absence of infection -",!!!!!?8,"6. Involvement of other kidney -",!!!!! D:$D(CMBN) HD2 W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!! D:'$D(CMBN) HD2 W $S($D(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!! W ?25,"Signature: ______________________________",!!?30,"Date: _________________________",! K LN,LN1,LN2 Q ; HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for "_NAME,!! W HD8,!,HD7,!!! Q ; SETIOF ; ** Set device control var's D HOME^%ZIS Q