| 1 | DVBCCYCK ;ALB/GTS-557/THM-CYSTITIS,BLADDER CALCULUS,ETC ; 2/6/91 7:59 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:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
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| 7 | W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 0605 Worksheet" S HD5="CYSTITIS, BLADDER CALCULUS, RESIDUALS OF BLADDER INJURY,",HD6="ALL DISORDERS OF THE PROSTATE, URETHRA AND SURGICAL RESIDUALS (GU)"
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| 8 | S HD7="For "_HD5
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| 9 | W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD7)\2)),HD7,!?(40-($L(HD6)\2)),HD6,!!
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| 10 | W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,! I '$D(CMBN) W "Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD5,!?14,HD6
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| 11 | W !!!!,"Narrative:"
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| 12 | W ?13,"Complications and/or medical side effects should always be",!?13,"reported, even when not specifically requested.",!!
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| 13 | I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",!!!!!!!!!!! D HD2
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| 14 | 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):",!!!
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| 15 | W ?8,"1. Frequency of urination -",!!!!!?8,"2. Presence or absence of pyuria -",!!!!!
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| 16 | W ?8,"3. Pain or tenesmus -",!!!!!?8,"4. Incontinence requiring pads or appliance -",!!!!!
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| 17 | 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: _________________________",!
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| 18 | K LN,LN1,LN2
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| 19 | Q
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| 20 | ;
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| 21 | HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for "_NAME,!!,HD5,!,HD6,!!!
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| 22 | Q
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| 23 | ;
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| 24 | SETIOF ; ** Set device control var's
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| 25 | D HOME^%ZIS
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| 26 | Q
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