| 1 | DVBCAACK ;ALB/GTS-557/THM-ALIMENTARY APPENDAGES ; 2/6/91  6:40 AM
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| 2 |  ;;2.7;AMIE;;Apr 10, 1995
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| 3 |  ;
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| 4 |  S PG=1,HD91="Department of Veterans Affairs"
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| 5 |  S HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
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| 6 | EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
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| 7 |  W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 305 Worksheet" S HD7="ALIMENTARY APPENDAGES (DIGESTIVE)",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
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| 8 |  W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",?14,HD7
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| 9 |  W !!!!,"Narrative:"
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| 10 |  W ?13,"Detailed description of chronic, active symptomatology in the",!?13,"""subjective complaints"" portion of this or the main examination is",!?13,"critical to the degree of disability assigned for the veteran.",!!
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| 11 |  I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",!!!!!!!!!! D:'$D(CMBN) HD2
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| 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):",!!!?8,"1. Abdominal discomfort -",!!!!!!
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| 13 |  W ?8,"2. Food intolerance -",!!!!!!?8,"3. Nausea (frequency) -",!!!!!!?8,"4. Vomiting (frequency) -",!!!!!!?8,"5. Degree of pain -",!!!!!! D:$D(CMBN) HD2 W ?8,"6. Anorexia -",!!!!!!
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| 14 |  W ?8,"7. Malaise -",!!!!!! D:'$D(CMBN) HD2 W ?8,"8. Weight loss -",!!!!!!?8,"9. Generalized weakness -",!!!!!!
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| 15 |  W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!,$S($D(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
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| 16 |  K LN,LN1,LN2
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| 17 |  Q
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| 18 |  ;
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| 19 | HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for "_NAME,!
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| 20 |  W HD8,!!!
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| 21 |  Q
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| 22 | SETIOF ;  ** Set device control variables **
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| 23 |  D HOME^%ZIS
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| 24 |  Q
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