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1DVBCNHCK ;ALB/GTS-557/THM-NEPHROLOGICAL EXAM ; 12/27/90 1:07 PM
2 ;;2.7;AMIE;;Apr 10, 1995
3 ;
4 S PG=1,HD91="Department of Veterans Affairs",HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
5EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
6 W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1110 Worksheet" S HD7="NEPHROLOGICAL",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
7 W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: NEPHROLOGICAL"
8 W !!!!,"Narrative:"
9 W ?13,"Complications and/or medical side effects should always be",!?13,"reported, even when not specifically requested.",!!
10 I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",! D HD2
11 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):",!
12 W !!?8,"1. Report presence or absence of calculi -",!!!!!?8,"2. If stone, presence and size if retained -",!!!!!?8,"3. Frequency of attacks of colic -",!!!!!?8,"4. Catheter drainage requirments, including frequency -",!!!!!
13 W ?8,"5. Presence or absence of infection -",!!!!!?8,"6. Involvement of other kidney -",!!!!!
14 D:$D(CMBN) HD2 W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!! D:'$D(CMBN) HD2 W $S($D(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!
15 W ?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
16 K LN,LN1,LN2
17 Q
18 ;
19HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for "_NAME,!,HD8,!!!
20 Q
21 ;
22SETIOF ; ** Set device control var's
23 D HOME^%ZIS
24 Q
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