source: FOIAVistA/trunk/r/AUTOMATED_MED_INFO_EXCHANGE-DVBA-DVBC/DVBCSMCK.m@ 1712

Last change on this file since 1712 was 628, checked in by George Lilly, 15 years ago

initial load of FOIAVistA 6/30/08 version

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1DVBCSMCK ;ALB/GTS-557/THM-SENSE OF SMELL ; 12/27/90 1:40 PM
2 ;;2.7;AMIE;;Apr 10, 1995
3 ;
4 S PG=1,HD91="Department of Veterans Affairs",HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
5EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
6 W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1320 Worksheet" S HD7="SENSE OF SMELL",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
7 W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
8 W !!!!,"Narrative:"
9 W ?13,"Report whether loss is partial or complete and whether it",!?13,"is on an organic or psychiatric basis. If a psychiatric",!?13,"basis is suspected, a special psychiatric examination should",!?13,"be ordered.",!!!
10 I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",! D HD2
11 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):",!!!
12 W ?4,"Substances used for testing olfaction and results (each side of nose",!?8,"should be tested separately):"
13 W !!?8,"1. Coffee -",!!!?8,"2. Benzaldehyde -",!!!?8,"3. Tar -",!!!
14 W ?8,"4. Oil of lemon -",!!!?8,"5. Other (state substance) -",!!!
15 W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!! D:$Y>50 HD2 W $S($D(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
16 K LN,LN1,LN2
17 Q
18 ;
19HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",HD7,!,"for ",NAME,!!!
20 Q
21SETIOF ; ** Set device control var's
22 D HOME^%ZIS
23 Q
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