source: FOIAVistA/trunk/r/REMOTE_ORDER_ENTRY_SYSTEM-RMPF-RMPJ/RMPFQP2.m

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

initial load of FOIAVistA 6/30/08 version

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1RMPFQP2 ;DDC/KAW-PRINT VA FORM 10-2477a; [ 06/16/95 3:06 PM ]
2 ;;2.0;REMOTE ORDER/ENTRY SYSTEM;;JUN 16, 1995
3RMPFSET I '$D(RMPFMENU) D MENU^RMPFUTL I '$D(RMPFMENU) W !!,$C(7),"*** A MENU SELECTION MUST BE MADE ***" Q ;;RMPFMENU must be defined
4 I '$D(RMPFSTAN)!'$D(RMPFDAT)!'$D(RMPFSYS) D ^RMPFUTL Q:'$D(RMPFSTAN)!'$D(RMPFDAT)!'$D(RMPFSYS)
5 ;; input: None
6 ;;output: None
7 F KX=1:1:RMPFCNT D PRINT
8 G END
9PRINT D ^RMPFQP1
10 W:$Y>0 @IOF W !?25,"DEPARTMENT OF VETERANS AFFAIRS"
11 W !?21,"AUDIOLOGICAL SERVICES ACKNOWLEDGEMENT"
12 D LINE
13 W !,"1. Extended Audiology Clinic",?38,"| 2. Issuing Audiology Clinic"
14 W !?3,"Station No. ",RMPFRSTA,?38,"|",?45,"Station No. ",RMPFSTAP
15 W !?38,"|"
16 F I=1:1:4 W ! W:$D(RMPFR(I)) ?3,$E(RMPFR(I),1,32) W ?38,"|" W:$D(RMPFS(I)) ?45,$E(RMPFS(I),1,36)
17 D LINE
18NAM W !,"3. Veteran's Name and Address ",?38,"| 4. Eligibility Status(es) "
19 W !,?38,"|"
20 W ! W ?38,"| __ SC for Hearing",?61,"__ IN PAT"
21 W ! W ?38,"| __ 50-100% SC",?61,"__ NHCU"
22 W ! W ?38,"| __ POW",?61,"__ DOM"
23 W ! W ?38,"| __ WWI",?61,"__ OPT-NSC"
24 W ! W ?38,"| __ MBW",?61,"__ ADJ"
25 W !?38,"| __ A&A",?54,"__ ALLIED (Authority Req.)"
26 W !?38,"| __ HB",?54,"__ OTHER (Specify)"
27 D LINE
28 D CONT G END:$D(RMPFOUT) D LINE:IOST?1"C-".E
29 W !,"5. Soc. Security No.",?16,"| 6. VA Claim No.",?38,"| 7. Date of Birth",?59,"| 8. Disability Code"
30 W !?20,"|",?38,"|",?59,"|"
31 W !," - -",?20,"| - -",?38,"|",?59,"| __DEAF/U __DEAF/B"
32 D LINE
33AUTH W !,"9. Currently Authorized Hearing Aid(s)"
34 D LINE
35 W !?2,"Manfacturer",?16,"|",?22,"Model",?32,"|",?34,"Serial Number",?48,"|",?50,"Furnished By",?64,"|",?67,"Date Issued"
36 D LINE
37 F I=1:1:4 W !,?16,"|",?32,"|",?48,"|",?64,"|" D LINE
38CLINIC W !,"10. Clinic Action Taken __ VETERAN DOES NOT REQUIRE NEW HEARING AID"
39 W !?27,"__ VETERAN DOES NOT REQUIRE HEARING AID"
40 W !?27,"__ ITEM(S) LISTED BELOW WERE ISSUED TO VETERAN"
41 D LINE
42 D CONT G END:$D(RMPFOUT) D LINE:IOST?1"C-".E
43 W !,?16,"|",?27,"|",?44,"|",?57,"| Battery",?67,"| Serial No."
44 W !,"Natl. Stock No.",?16,"|",?20,"Make",?33,"Model"
45 W ?44,"| Serial No.",?57,"| Type",?67,"| Replaced"
46 D LINE
47 F I=1:1:2 W !,"6515-01-",?16,"|",?27,"|",?44,"|",?57,"|",?67,"|" D LINE
48 D CONT G END:$D(RMPFOUT) D LINE:IOST?1"C-".E
49 W !,"11. Type of Fitting",?24,"__ MONAURAL",?38,"__ BINAURAL",?56,"__ CROS",?69,"__ BICROS"
50 D LINE
51 W !,"12. Authorized Usage of Aids",?38,"__ MONAURAL",?56,"__ BINAURAL"
52 D LINE
53 W !,"13. Issued aids to be replaced to clinic stock by DDC:",?58,"__ YES",?66,"__ NO",?73,"__ N/A"
54 D LINE
55 W !,"14. Signature of Issuing Audiologist",?38,"|",?44,"Name and Title",?65,"|15. Order Date"
56 W !?38,"|",?65,"|",!?38,"|",?65,"|"
57 D LINE
58 I IOST?1"P-".E,$Y>58 W @IOF
59 W !,"16. I certify that I have",?37,"Signature of Veteran",?65,"|17. Date"
60 W !?4,"received the item(s)",?65,"|"
61 W !?4,"listed under 10 above ->",?65,"|"
62 D LINE
63 W !,"VA Form 10-2477a"
64 W !,"SEP 1991"
65 D CONT G END:$D(RMPFOUT) W:IOST?1"P-".E @IOF
66 D:$D(IO("S")) ^%ZISC
67END K RMPFRSTA,RMPFR,RMPFS,RMPFRSTA,RMPFS,RMPFR,%DT,I,IN,Y,RMPFOUT,RMPFQUT,RMPFCNT Q
68READ K RMPFOUT,RMPFQUT
69 R Y:DTIME I '$T W $C(7) R Y:5 G READ:Y="." S:'$T Y=U
70 I Y?1"^".E S (RMPFOUT,Y)="" Q
71 S:Y?1"?".E (RMPFQUT,Y)=""
72 Q
73LINE W !,"--------------------------------------------------------------------------------"
74 Q
75CONT Q:IOST'["C-" F I=1:1 Q:$Y>21 W !
76 W !,"Enter <RETURN> to continue:" D READ Q:$D(RMPFOUT)
77 I $D(RMPFQUT) W !!,"Enter <RETURN> to continue or <^> to exit." G CONT
78 W @IOF Q
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