source: internationalization/trunk/TranslationSpreadsheets/WV-DIALOG-0016.txt@ 1798

Last change on this file since 1798 was 604, checked in by George Lilly, 15 years ago

Internationalization

File size: 9.2 KB
Line 
1English French Notes Complete/Exclude
2Do you wish to return to Screen #9 to enter missing Income Data?
3A means test for this encounter date was not found and may be required!
4Further investigation will be needed.
5Press ENTER to continue
6Patient Requires a means Test
7Primary Means Test Required from '
8SCENI MEANS TEST EDIT
9You do not have the appropriate IEMM Security Key. Contact your supervisor.
10Do you wish to proceed with the means test at this time
11No registrations to print from.
12Registration date/time:
13Enter the date and time, Entry #, or 'L' for the last registration,
14 to select the registration you wish to print a 10/10 for.
15This output requires 132 column output to a PRINTER.
16Output to SCREEN will be unreadable.
17FACILITY NOT IDENTIFIED
18APPLICATION FOR MEDICAL BENEFITS
19PRINT
20ENTER 'Y'ES TO PRINT A
21. OTHERWISE ENTER 'N'O.
22NOT APPLICABLE
23SEE ATTACHMENT FOR PAPERWORK REDUCTION INFORMATION AND PRIVACY ACT INFORMATION
24PART I - PATIENT DATA
251. Type of benefit applied for:
26HOSPITAL/OUTPATIENT TREATMENT^DOMICILIARY CARE^HOSPITAL/OUTPATIENT TREATMENT^OUTPATIENT DENTAL^NURSING HOME CARE
27 3. Other names used (Alias)
28 4. Social Security Number
295. Claim Number
30| 6. LOCATION OF CLAIMS FOLDER
31| 7. DATE OF BIRTH
32| 8. PLACE OF BIRTH
339. PERMANENT ADDRESS
34 10. TEMPORARY ADDRESS
359A. STREET ADDRESS:
36 10A. STREET ADDRESS:
379D. ZIP CODE:
3810D. ZIP CODE:
399F. HOME TELEPHONE NUMBER:
4010F. HOME TELEPHONE NUMBER:
4111. CONFIDENTIAL ADDRESS
42Not Applicable
4311A. STREET ADDRESS:
4411D. ZIP CODE:
45| 11F. START DATE:
46| STOP DATE:
4711G. Active Confidential Address Categories
4813. MOTHER'S MAIDEN NAME
4916. RELIGIOUS PREFERENCE
5017. DATE OF PREVIOUS CARE
5118. LOCATION OF PREVIOUS CARE
5219. SPINAL CORD INJURY
53PARAPLEGIA-TRAUMATIC
54QUADRIPLEGIA-TRAUMATIC
55PARAPLEGIA-NONTRAUMATIC
56QUADRIPLEGIA-NONTRAUMATIC
57PART II - EMERGENCY CONTACT DATA
581A. FIRST NEXT OF KIN
592A. SECOND NEXT OF KIN
603A. FIRST CONTACT IN AN EMERGENCY
614A. SECOND CONTACT IN AN EMERGENCY
62C. HOME TELEPHONE NUMBER
63D. WORK TELEPHONE NUMBER
64E. ADDRESS (Number, Street, City, State, ZIP Code)
65Reg Date/Time:
66PRINTED:
67Clerk:
68AUTOMATED VA FORM 10-10
69PART III - APPLICANT/SPOUSE DATA
701. APPLICANT'S EMPLOYMENT STATUS:
712. SPOUSE'S EMPLOYMENT STATUS:
723. APPLICANT INFORMATION
733B. EMPLOYER (Name, Street Address, City, State, Zip)
744B. EMPLOYER (Name, Street Address, City, State, Zip)
753C. WORK TELEPHONE NUMBER:
764C. WORK TELEPHONE NUMBER:
77NOT ANSWERED
78PART IV - MILITARY SERVICE DATA
791A. LAST BRANCH OF SERVICE
801B. LAST SERVICE NUMBER
811C. LAST DATE OF ENTRY
821D. LAST DISCHARGE DATE
831E. DISCHARGE TYPE
842A. PRIOR BRANCH OF SERVICE
852B. PRIOR SERVICE NUMBER
862C. PRIOR DATE OF ENTRY
872D. PRIOR DISCHARGE DATE
882E. DISCHARGE TYPE
893A. PRIOR BRANCH OF SERVICE
903B. PRIOR SERVICE NUMBER
913C. PRIOR DATE OF ENTRY
923D. PRIOR DISCHARGE DATE
933E. DISCHARGE TYPE
94PART V - ELIGIBILITY STATUS DATA
951. PATIENT TYPE:
962. IS NEED FOR MEDICAL CARE RELATED TO AN
973. IS THE NEED FOR MEDICAL CARE RELATED
984. IS PATIENT ELIGIBLE FOR MEDICAID:
99 ON THE JOB INJURY:
100TO AN ACCIDENT:
1015A. DOES PATIENT HAVE HEALTH INSURANCE
1025B. IF YES, COVERAGE PROVIDED BY:
103COVERAGE:
104PATIENT'S INSURANCE
105SPOUSE'S INSURANCE
106NO ACTIVE (UNEXPIRED) INSURANCE ON FILE FOR THIS APPLICANT
1076. DOES VETERAN HAVE GI
1087. PRIMARY ELIGIBILITY CODE
1098. OTHER ELIGIBILITY CODE
1109. PERIOD OF SERVICE
111INSURANCE:
11210. SERVICE CONNECTED CONDITIONS AS STATED BY APPLICANT:
11310. RATED SERVICE CONNECTED CONDITIONS:
114NO RATED SERVICE-CONNECTED CONDITIONS
11510. SERVICE CONNECTED CONDITIONS:
116NOT APPLICABLE: NOT A SERVICE-CONNECTED APPLICANT
117PART VI - INCOME SCREENING DATA OR ANNUAL INCOME
1181A. CURRENT MARITAL STATUS:
1191B. DATE OF MARRIAGE:
1202A. WAS PATIENT MARRIED OR SEPARATED AT THE END OF LAST CALENDAR YEAR?:
1212B. NAME OF SPOUSE
1222C. SEX OF SPOUSE
1232D. SPOUSE'S SOCIAL SECURITY NO
1242E. SPOUSE'S DATE OF BIRTH
125B. SOCIAL SECURITY NO
126D. DATE OF BIRTH
127F. DEPENDENT AS
128NONE INDICATED
1294. PREVIOUS CALENDAR YEAR (
130) INCOME INFORMATION
131CHECK ALL APPLICABLE BOXES
13211. TOTAL INCOME
133PART VII - INELIGIBLE/MISSING DATA
1341. INELIGIBLE DATE
1352. TWX SOURCE
1363. TWX CITY
1374. TWX STATE
1386. VACO DECISION:
1397. MISSING DATE
1408. TWX SOURCE
1419. TWX CITY
14210. TWX STATE
1431. ELIGIBILITY STATUS
1442. STATUS DATE
1453. STATUS ENTERED BY
146PENDING VERIFICATION
147RE-VERIFY
1484. VERIFICATION METHOD
1495. SERVICE VERIFICATION DATE
1506. RATED DISABILITIES
151SIGNATURE OF APPLICANT OR APPLICANT'S REPRESENTATIVE
152FOR VA USE ONLY
153VA FACILITY NUMBER
154ADMISSION DATE
155AUTHORITY FOR ADMISSION OR TREATMENT
156SUPPLEMENTAL DATA SHEET
157HEALTH SUMMARY
158DRUG PROFILE
159ENCOUNTER FORMS
160No Type Selected. HS will not print
161Select type of Drug Profile
16211. OTHER ELIGIBILITY DATA
163L. SERVICE IN PERSIAN GULF THEATER
164B. PRISONER OF WAR STATUS
165M. DENTAL INJ. |
166 TEETH EXTRACTED
167C. EXPOSURE TO AGENT ORANGE
168N. SERVICE CONNECTED
169D. EXPOSURE TO RADIATION
170O. RECEIVING AID & ATTENDANCE
171E. COMBAT SERVICE
172P. RECEIVING HOUSEBOUND
173F. MILITARY DISABILITY
174Q. RECEIVING VA PENSION
175G. VIETNAM SERVICE
176R. RECEIVING VA DISABILITY
177H. LEBANON SERVICE
178S. SERVICE IN SOMALIA
179I. GRENADA SERVICE
180T. SERVICE IN YUGOSLAVIA
181J. PANAMA SERVICE
182U. PURPLE HEART RECIPIENT
183K. PERSIAN GULF SERVICE
184V. VA MONETARY AMOUNT:
1853. Other Name(s):
186NO ALIAS' ON FILE
187NO REMARKS CURRENTLY ENTERED FOR THIS APPLICANT
1885. Fathers Name:
189NOT SPECIFIED
190Mothers Name:
191Mothers Maiden Name:
1926a. Enrollment Clinic(s):
193NOT ACTIVELY ENROLLED IN ANY CLINICS AT THIS TIME
1946b. Future Appointments:
195NO PENDING APPOINTMENTS ON FILE
1967a. Last Admission:
197NO PREVIOUS ADMISSIONS TO THIS FACILITY ON FILE
198LAST ADMISSION PTF DATA NO LONGER STORED
1997b. Discharge Diagnosis(es):
200NO DIAGNOSES ON FILE FOR THIS ADMISSION PERIOD YET
2017c. Admit Diagnosis:
2027d. Diagnosis Responsible for Greatest Length of Stay:
2038. Eligibility Status:
204PENDING RE-VERIFICATION
205UNKNOWN OR NONE
206| Status Date:
207Verification Method:
208ELIGIBLE APPLICANT -- NOT APPLICABLE
209Ineligible Date:
210CITY UNKNOWN
211STATE UNKNOWN
212VARO DECISION UNKNOWN
213| TWX Source:
214TWX City:
215| TWX State:
216VARO Decision:
2179. Vietnam Service:
218From:
219To :
220Agent Orange:
221Reg :
222Exam :
223Reg #:
224Loc:
225ION Radiation:
226Method:
227Prisoner of War:
228Where:
229Combat:
230Purple Heart:
231Status:
232Remarks:
23310. Next of Kin, Address and Zip Code:
234Name:
235KOREAN DMZ
236NAGASAKI/HIROSHIMA
237NUCLEAR TESTING
238NUCLEAR TESTING & NAGASAKI/HIROSHIMA
239STREET ADDRESS UNKNOWN
240CITY STATE UNKNOWN
241GLOBAL SUBSCRIPT LOCATION
242Unknown/Invalid pointer, DD(
243GLOBAL NAME
244Cannot convert the
245 in the
246 File 11 and 13 Conversion Problem list
247MARITAL STATUS (#11) File Conversion Problems:
248RELIGION (#13) File Converion Problems:
249No problems
250Pointer File/Subfile^Field^Problem Description
251DG*5.3*172
252DGY(
253File 11 and 13 Conversion Problems
254*** Conversion is not necessary! ***
255Uninstalling patch...
256*** Not all non-standard entries have been mapped...see DG172 options ***
257*** Job appears to already be running! ***
258Are you sure you want to start the conversion process
259Marital/Religion File Conversion
260Are you sure you want to stop the background conversion process
261*** Job will stop soon ***
262*** Conversion process is NOT running! ***
263RGPR PRE-IMP MENU
264DG172
265RELIGION/MARITAL STATUS REINDEX
266Reindex Religion and Marital Status file xrefs ...
267Setting up files that need to be converted...
268Setting up standard/non-standard mapping file...
269You can not re-start this process!
270*** No mapping necessary! ***
271Select Non-Standard
272Marital Status:
273Religion:
274Religion/Marital Status Conversion
275Conversion Finished
276DG172(1,
277Conversion *NOT* Finished
278The conversion process appears to have been stopped.
279To finish the conversion process, restart by using
280the 'Begin Religion/Marital Status Conversion' option
281on the CIRN Pre-Implementation Menu.
282Marital Status
283Religion
284 File Non-Standard Entries:
285All non-standard entries listed above have been removed
286from their respective files.
287Entry:
288 repointed to:
289 Starting post-install process...
290 Post-install process has completed.
291 total records have been identified and corrected.
292Report cancelled!
293Means Test Update Report
294Updated Means Test Listing
295Run Date:
296Veteran Name
297Veteran SSN
298Year
299Old Status
300New Status
301Income Year
302Old Means Test Status
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