| 1 | DVBCWDM1 ;ALB/CMM DIGESTIVE, MISC. DISEASES WKS TEXT - 1 ; 5 MARCH 1997 | 
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| 2 | ;;2.7;AMIE;**12**;Apr 10, 1995 | 
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| 3 | ; | 
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| 4 | ; | 
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| 5 | TXT ; | 
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| 6 | ;;A.  Review of Medical Records: | 
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| 7 | ;; | 
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| 8 | ;; | 
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| 9 | ;;B.  Medical History (Subjective Complaints): | 
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| 10 | ;; | 
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| 11 | ;;    1.  Describe all hernia surgery and results. | 
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| 12 | ;; | 
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| 13 | ;; | 
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| 14 | ;;    2.  For malignancy, state type of treatment, dates of treatment, | 
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| 15 | ;;        including last date treatment if it has ended. | 
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| 16 | ;; | 
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| 17 | ;; | 
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| 18 | ;;    3.  For peritoneal tuberculosis, state date of diagnosis, treatment, | 
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| 19 | ;;        and date on which inactivity was established. | 
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| 20 | ;; | 
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| 21 | ;; | 
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| 22 | ;;C.  Physical Examination (Objective Findings): | 
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| 23 | ;; | 
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| 24 | ;;    Address each of the following and fully describe current findings: | 
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| 25 | ;;    1.  For inguinal or ventral hernia, state whether reducible, how | 
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| 26 | ;;        well supported by truss or belt, and whether irremediable or | 
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| 27 | ;;        inoperable. | 
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| 28 | ;; | 
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| 29 | ;; | 
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| 30 | ;;    2.  For ventral hernia, state size of hernia, extent of diastasis | 
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| 31 | ;;        of recti muscles, status of muscles and fascia of abdominal wall. | 
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| 32 | ;; | 
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| 33 | ;; | 
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| 34 | ;;    3.  All residuals of malignancy, including residuals from treatment. | 
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| 35 | ;; | 
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| 36 | ;; | 
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| 37 | ;;D.  Diagnostic and Clinical Tests: | 
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| 38 | ;; | 
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| 39 | ;;1.  Include results of all diagnostic and clinical tests conducted in | 
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| 40 | ;;    the examination report. | 
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| 41 | ;; | 
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| 42 | ;; | 
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| 43 | ;;E.  Diagnosis: | 
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| 44 | ;; | 
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| 45 | ;; | 
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| 46 | ;;Signature:                             Date: | 
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| 47 | ;;END | 
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