DVBCWDM1 ;ALB/CMM DIGESTIVE, MISC. DISEASES WKS TEXT - 1 ; 5 MARCH 1997 ;;2.7;AMIE;**12**;Apr 10, 1995 ; ; TXT ; ;;A. Review of Medical Records: ;; ;; ;;B. Medical History (Subjective Complaints): ;; ;; 1. Describe all hernia surgery and results. ;; ;; ;; 2. For malignancy, state type of treatment, dates of treatment, ;; including last date treatment if it has ended. ;; ;; ;; 3. For peritoneal tuberculosis, state date of diagnosis, treatment, ;; and date on which inactivity was established. ;; ;; ;;C. Physical Examination (Objective Findings): ;; ;; Address each of the following and fully describe current findings: ;; 1. For inguinal or ventral hernia, state whether reducible, how ;; well supported by truss or belt, and whether irremediable or ;; inoperable. ;; ;; ;; 2. For ventral hernia, state size of hernia, extent of diastasis ;; of recti muscles, status of muscles and fascia of abdominal wall. ;; ;; ;; 3. All residuals of malignancy, including residuals from treatment. ;; ;; ;;D. Diagnostic and Clinical Tests: ;; ;;1. Include results of all diagnostic and clinical tests conducted in ;; the examination report. ;; ;; ;;E. Diagnosis: ;; ;; ;;Signature: Date: ;;END