DVBCBRCK ;ALB/GTS-557/THM-TRACHEA AND BRONCHI ; 6/27/91 7:33 AM
;;2.7;AMIE;;Apr 10, 1995
;
S PG=1,HD91="Department of Veterans Affairs"
S HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1525 Worksheet" S HD7="TRACHEA AND BRONCHI",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
W !!!!,"Narrative:"
W ?13,"Identify the disease present, describe clinical findings",!?13,"and provide current chest X-Ray results if no recent",!?13,"studies are available. Report pulmonary function studies"
W !?13,"unless medically contraindicated.",!!!
I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",!! D HD2
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):",!!!
W ?8,"1. Presence of cor pulmonale -",!!!!!
W ?8,"2. If veteran is asthmatic, report frequency of attacks",!?11,"and baseline functional status between attacks -",!!!!!!
W ?8,"3. Report any indications of cyanosis/clubbing of extremities -",!!!!!!?8,"4. Productive cough/sputum -",!!!!!!?8,"5. Dyspnea on exertion/slight exertion/at rest -",!!!!!
W ?8,"6. Indicate whether infectious disease is present -",!!!!!!!
D:$D(CMBN) HD2 W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clincal test results:",!!!!!!!!!! D:'$D(CMBN) HD2
W $S($D(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
K LN,LN1,LN2
Q
;
HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",HD7,!,"for ",NAME,!!!
Q
;
SETIOF ; ** Set device control var's
D HOME^%ZIS
Q
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCBRCK 2020 printed Nov 22, 2024@16:53:52 Page 2
DVBCBRCK ;ALB/GTS-557/THM-TRACHEA AND BRONCHI ; 6/27/91 7:33 AM
+1 ;;2.7;AMIE;;Apr 10, 1995
+2 ;
+3 SET PG=1
SET HD91="Department of Veterans Affairs"
+4 SET HD9=$SELECT($DATA(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
EN if '$DATA(IOF)
DO SETIOF
if (IOST?1"C-".E)
WRITE @IOF
+1 WRITE !?25,HD91,!?22,"Compensation and Pension Examination",!
WRITE ?33,"# 1525 Worksheet"
SET HD7="TRACHEA AND BRONCHI"
SET HD8="For "_HD7
WRITE !?(40-($LENGTH(HD9)\2)),HD9,!?(40-($LENGTH(HD8)\2)),HD8,!!
+2 WRITE !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
+3 WRITE !!!!,"Narrative:"
+4 WRITE ?13,"Identify the disease present, describe clinical findings",!?13,"and provide current chest X-Ray results if no recent",!?13,"studies are available. Report pulmonary function studies"
+5 WRITE !?13,"unless medically contraindicated.",!!!
+6 IF '$DATA(CMBN)
WRITE "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",!!
DO HD2
+7 WRITE $SELECT($DATA(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):",!!!
+8 WRITE ?8,"1. Presence of cor pulmonale -",!!!!!
+9 WRITE ?8,"2. If veteran is asthmatic, report frequency of attacks",!?11,"and baseline functional status between attacks -",!!!!!!
+10 WRITE ?8,"3. Report any indications of cyanosis/clubbing of extremities -",!!!!!!?8,"4. Productive cough/sputum -",!!!!!!?8,"5. Dyspnea on exertion/slight exertion/at rest -",!!!!!
+11 WRITE ?8,"6. Indicate whether infectious disease is present -",!!!!!!!
+12 if $DATA(CMBN)
DO HD2
WRITE $SELECT($DATA(CMBN):"B. ",1:"E. "),"Diagnostic/clincal test results:",!!!!!!!!!!
if '$DATA(CMBN)
DO HD2
+13 WRITE $SELECT($DATA(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
+14 KILL LN,LN1,LN2
+15 QUIT
+16 ;
HD2 SET PG=PG+1
WRITE @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",HD7,!,"for ",NAME,!!!
+1 QUIT
+2 ;
SETIOF ; ** Set device control var's
+1 DO HOME^%ZIS
+2 QUIT
