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| 1 | DVBCWED1 ;ALB/CMM EAR DISEASE WKS TEXT - 1 ; 6 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 | ;; | 
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| 10 | ;;B.  Medical History (Subjective Complaints): | 
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| 11 | ;; | 
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| 12 | ;; | 
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| 13 | ;; | 
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| 14 | ;;C.  Physical Examination (Objective Findings): | 
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| 15 | ;; | 
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| 16 | ;;    1.  Address each of the following and describe current findings, | 
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| 17 | ;;        including abnormalities of size, shape, or form: | 
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| 18 | ;; | 
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| 19 | ;;        a.  Auricle. | 
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| 20 | ;; | 
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| 21 | ;; | 
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| 22 | ;;        b.  External canal. | 
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| 23 | ;; | 
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| 24 | ;; | 
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| 25 | ;; | 
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| 26 | ;;        c.  Tympanic membrane. | 
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| 27 | ;; | 
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| 28 | ;; | 
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| 29 | ;;        d.  The tympanum. | 
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| 30 | ;; | 
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| 31 | ;; | 
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| 32 | ;;        e.  The mastoid. | 
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| 33 | ;; | 
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| 34 | ;; | 
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| 35 | ;;        f.  All conditions secondary to ear disease, such as disturbance | 
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| 36 | ;;            of balance, upper respiratory disease, hearing loss, etc. | 
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| 37 | ;; | 
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| 38 | ;; | 
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| 39 | ;;    2.  State whether an active ear disease is present. | 
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| 40 | ;; | 
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| 41 | ;; | 
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| 42 | ;;    3.  Infections of the middle or inner ear. | 
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| 43 | ;; | 
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| 44 | ;; | 
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| 45 | ;;D.  Diagnostic and Clinical Tests: | 
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| 46 | ;; | 
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| 47 | ;;    1.  Include results of all diagnostic and clinical tests conducted | 
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| 48 | ;;        in the examination report. | 
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| 49 | ;; | 
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| 50 | ;; | 
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| 51 | ;;E.  Diagnosis: | 
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| 52 | ;; | 
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| 53 | ;; | 
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| 54 | ;;Signature:                             Date: | 
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| 55 | ;;END | 
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