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on this file since 1726 was 613, checked in by George Lilly, 15 years ago |
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[613] | 1 | DVBCWML1 ;ALB/CMM MOUTH, LIPS AND TONGUE WKS TEXT - 1 ; 5 MARCH 1997
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| 2 | ;;2.7;AMIE;**12**;Apr 10, 1995
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| 3 | ;
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| 4 | ;
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| 5 | TXT ;
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| 6 | ;;A. Review of Medical Records:
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| 7 | ;;
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| 8 | ;;
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| 9 | ;;
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| 10 | ;;B. Medical History (Subjective Complaints):
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| 11 | ;;
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| 12 | ;;
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| 13 | ;;
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| 14 | ;;C. Physical Examination (Objective Findings):
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| 15 | ;;
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| 16 | ;; Address each of the following and fully describe current findings:
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| 17 | ;; 1. Disfigurement - if present, order COLOR PHOTOGRAPHS.
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| 18 | ;;
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| 19 | ;;
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| 20 | ;; 2. Interference with mastication.
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| 21 | ;;
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| 22 | ;;
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| 23 | ;; 3. Interference with speech - state extent.
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| 24 | ;;
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| 25 | ;;
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| 26 | ;; 4. Absence of all or part of tongue - describe.
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| 27 | ;;
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| 28 | ;;
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| 29 | ;;D. Diagnostic and Clinical Tests:
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| 30 | ;;
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| 31 | ;; 1. Include results of all diagnostic and clinical tests conducted
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| 32 | ;; in the examination report.
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| 33 | ;;
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| 34 | ;;
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| 35 | ;;E. Diagnosis:
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| 36 | ;;
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| 37 | ;;
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| 38 | ;;Signature: Date:
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| 39 | ;;END
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