| [613] | 1 | DVBCPYCK ;ALB/GTS-ALB/GTS-557/THM-PYELITIS, NEPHROLITHIASIS,ETC ; 2/6/91 7:56 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",HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
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| 5 | EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
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| 6 | W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 0620 Worksheet" S HD6="PYELITIS, NEPHROLITHIASIS, URETEROLITHIASIS,",HD7="URETERAL STRICTURE AND HYDRONEPHROSIS (GU)",HD8="For "_HD6
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| 7 | W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!,?(80-$L(HD7)\2),HD7,!!
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| 8 | W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD6,!?14,HD7
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| 9 | W !!!!,"Narrative:"
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| 10 | W ?13,"Complications and/or medical side effects should always be",!?13,"reported, even when not specifically requested.",!!
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| 11 | I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",! D 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):",!!!
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| 13 | W ?8,"1. Report presence or absence of calculi -",!!!!!
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| 14 | W ?8,"2. If stone, presence and size if retained -",!!!!!
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| 15 | W ?8,"3. Frequency of attacks of colic -",!!!!!?8,"4. Catheter drainage requirement (frequency of need) -",!!!!!
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| 16 | W ?8,"5. Presence or absence of infection -",!!!!!?8,"6. Involvement of other kidney -",!!!!!
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| 17 | 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:",!!!!!!!!!!
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| 18 | W ?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
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| 19 | K LN,LN1,LN2
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| 20 | Q
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| 21 | ;
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| 22 | HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for "_NAME,!!
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| 23 | W HD8,!,HD7,!!!
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| 24 | Q
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| 25 | ;
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| 26 | SETIOF ; ** Set device control var's
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| 27 | D HOME^%ZIS
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| 28 | Q
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