| [613] | 1 | DVBCPWC3 ;ALB ISC/THM-POW PROTOCOL SOCIAL WORK SURVEY ; 5/5/91 1:40 PM
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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",HD9="Full Exam Worksheet"
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| 5 | EN W @IOF,!?25,HD91,!?22,"Compensation and Pension Examination",! S HD7="SOCIAL WORK SURVEY - POW PROTOCOL",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!!
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| 6 | W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
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| 7 | W !!,"Physician's Guide Reference: Chapter 17",!!
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| 8 | W !!,"A. Describe the veteran's personal appearance -",!!!!!!!!!!
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| 9 | W "B. Describe the veteran's personal health -",!!!!!!!!!!,"C. Describe the veteran's family adjustment -",! D HD2
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| 10 | W "D. Describe the veteran's community adjustment -",!!!!!!!!!!,"E. Describe the veteran's economic adjustment -",!!!!!!!!!!
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| 11 | W "E. Evaluation:",!!!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
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| 12 | K LN,LN1,LN2
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| 13 | Q
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| 14 | ;
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| 15 | HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",HD7,!,"for ",NAME,!!!
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| 16 | Q
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