DVBCTSCK ;ALB/GTS-557/THM-SENSE OF TASTE ; 12/27/90 1:41 PM ;;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:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1325 Worksheet" S HD7="SENSE OF TASTE",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!! W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7 W !!!!,"Narrative:" W ?13,"The recommended test substances are sugar, diluted acetic",!?13,"acid, quinine, and common salt. If electrogustrometry",!?13,"is available, it should be used as the preferred test for",! W ?13,"this exam. Report whether loss is partial or complete",!?13,"and whether it is on an organic basis. If a psychiatric",!?13,"basis is suspected, a special psychiatric examination",!?13,"should be ordered.",!!! I '$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,"Substances used for testing and results:",!!?13,"1. Sweet -",!!!?13,"2. Sour -",!!!?13,"3. Bitter -",!!! W ?13,"4. Salt -",!!!,$S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!! D:$Y>50 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 ",HD7,!,"for "_NAME,!!! Q SETIOF ; ** Set device control var's D HOME^%ZIS Q