1 | DVBCDICK ;ALB/GTS-557/THM-DIABETES INSIPIDUS ; 12/6/90 11:48 AM
|
---|
2 | ;;2.7;AMIE;;Apr 10, 1995
|
---|
3 | ;
|
---|
4 | S PG=1,HD91="Department of Veterans Affairs"
|
---|
5 | S HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
|
---|
6 | EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
|
---|
7 | W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 0405 Worksheet" S HD7="DIABETES INSIPIDUS",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
|
---|
8 | W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
|
---|
9 | W !!!!,"Narrative:"
|
---|
10 | S LX="TXT" F I=1:1 S LY=$T(@LX+I) Q:LY["END" W ?13,$P(LY,";;",2),!
|
---|
11 | W !! I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:" D HD2
|
---|
12 | 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):",!!!
|
---|
13 | W ?5,"1. Frequency of urination -",!!!!!!?5,"2. Frequency of excessive thirst -",!!!!!!?5,"3. Frequency of syncope -",!!!!!!?5,"4. Blood pressure readings -",!!!!!!?5,"5. Serum osmolality (m Osm/Kg) -",!!!!!!
|
---|
14 | W ?5,"6. Urine osmolality (m Osm/Kg) -",!!!!!! D:$D(CMBN) HD2
|
---|
15 | W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!!!!! D:'$D(CMBN) HD2 W $S($D(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
|
---|
16 | K LN,LN1,LN2
|
---|
17 | Q
|
---|
18 | ;
|
---|
19 | HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",HD7,!,"for ",NAME,!!!
|
---|
20 | Q
|
---|
21 | ;
|
---|
22 | SETIOF ; ** Set device control var's
|
---|
23 | D HOME^%ZIS
|
---|
24 | Q
|
---|
25 | ;
|
---|
26 | TXT ;
|
---|
27 | ;;When symptoms interfere with normal daily activities or job
|
---|
28 | ;;efficiency, it is essential that the extent of such handicaps
|
---|
29 | ;;be described.
|
---|
30 | ;;END
|
---|