DGBTCR1 ;ALB/SCK - BENEFICIARY TRAVEL FORM 70-3542d; 2/7/88@08:00 6/11/93@09:30 ;;1.0;Beneficiary Travel;;September 25, 2001 ;This routine is a modification of AIVBTPRT / pmg / GRAND ISLAND ;07 Jul 88 12:02 PM Q ;Called by DGBTCR PRINT K I S $P(I,"=",65)="" W !?66,"|",I,"|",!?7,VADM(1),?50 I $D(^DIC(13,+VADM(9),0)) W $P(^(0),"^",4) W ?66,"| VOUCHER FOR CASH REIMBURSEMENT OF BENEFICIARY TRAVEL EXPENSES |" W !?7,VAPA(1),?50,DGBTCC,?66,"|" K I S $P(I,"=",65)="" W ?67,I,"|" W !?7,VAPA(4),?40,DGBTST,?50,$P(VAPA(11),U,2),?66,"| 2. Name and Address of Issuing Health Care Facility",?131,"|" W !?66,"|",?131,"|" W !?7,DGBTSSN,?21,$E($P(VADM(10),"^",2),1),?22,$P(VADM(5),"^"),?30,DGBTDOB,?50,DGBTDIV,?66,"|",?88,$P(DGBTINS,"^"),?131,"|" W !?66,"|",?88 W:$P(DGBTINS1,"^")'="" $P(DGBTINS1,"^") W:$P(DGBTINS1,"^")="" $P(DGBTINS1,"^",2) W:$P(DGBTINS1,"^")=""&($P(DGBTINS1,"^",2)="") DGBTINS2 W ?131,"|" W !?7,VAEL(7),?19 I $D(^DIC(8,+VAEL(1),0)) W $P(^(0),"^",4) W ?21,DGBTSCP,?28 I $D(^DIC(21,+VAEL(2),0)) W $P(^(0),"^",3) W ?66,"|",?88 W:$P(DGBTINS1,"^",2)'=""&($P(DGBTINS1,"^")'="") $P(DGBTINS1,"^",2) W:$P(DGBTINS1,"^")'=""&($P(DGBTINS1,"^",2)="") DGBTINS2 W:$P(DGBTINS1,"^")=""&($P(DGBTINS1,"^",2)'="") DGBTINS2 W ?131,"|" W !?66,"|",?88 W:$P(DGBTINS1,"^")'=""&($P(DGBTINS1,"^",2)'="")&($P(DGBTINS,"^",2)'="") DGBTINS2 W ?131,"|" W !," 1. Patient Data Card Information",?66,"|",?131,"|" D LINE FISCAL W !,"| 3. Fiscal Symbols" W ?30,$P(DGBTRATE,"^",4),?131,"|" D LINE W !,"| 4. From (Place of Departure)",?66,"| 5. To (Destination)",?131,"|" RMV ; W !,"|",?66,"|",?131,"|" W !,"|",?12,$P(DGBTVAR("D"),"^"),?66,"|",?88,$P(DGBTVAR("T"),"^"),?131,"|" W !,"|",?12 W:$P(DGBTVAR("D"),"^",2)'="" $P(DGBTVAR("D"),"^",2) W:$P(DGBTVAR("D"),"^",2)="" $P(DGBTVAR("D"),"^",3) W:$P(DGBTVAR("D"),"^",2)=""&($P(DGBTVAR("D"),"^",3)="") DGBTFCTY W ?66,"|",?88 W:$P(DGBTVAR("T"),"^",2)'="" $P(DGBTVAR("T"),"^",2) W:$P(DGBTVAR("T"),"^",2)="" $P(DGBTVAR("T"),"^",3) W:$P(DGBTVAR("T"),"^",2)=""&($P(DGBTVAR("T"),"^",3)="") DGBTTCTY W ?131,"|" W !,"|",?12 W:$P(DGBTVAR("D"),"^",3)'="" $P(DGBTVAR("D"),"^",3) W:$P(DGBTVAR("D"),"^",2)'=""&($P(DGBTVAR("D"),"^",3)="") DGBTFCTY W ?66,"|",?88 W:$P(DGBTVAR("T"),"^",3)'="" $P(DGBTVAR("T"),"^",3) W:$P(DGBTVAR("T"),"^",2)'=""&($P(DGBTVAR("T"),"^",3)="") DGBTTCTY W ?131,"|" W !,"|",?12 W:$P(DGBTVAR("D"),"^",2)'=""&($P(DGBTVAR("D"),"^",3)'="") DGBTFCTY W ?66,"|",?88 W:$P(DGBTVAR("T"),"^",2)'=""&($P(DGBTVAR("T"),"^",3)'="") DGBTTCTY W ?131,"|" D LINE Q LINE K I S $P(I,"=",131)="" W !,"|",I,"|" Q