Prompt: !?25,HD91,!?22,"Compensation and Pension Examination",!
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Prompt: ?33,"# 0110 Worksheet"
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Prompt: ?33,"# 0110 Worksheet"
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Prompt: !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",?14,HD7
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Prompt: !!!!,"Narrative:"
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Prompt: ?13,"In developing the diagnosis of a cardiac condition, the",!?13,"NOMENCLATURE AND CRITERIA FOR DIAGNOSIS OF DISEASE",!
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Prompt: ?13,"OF THE HEART published by the New York Heart Association",!?13,"serves as an acceptable standard. If a stress test",!
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Prompt: ?13,"could be conducted without cardiovascular contraindications",!?13,"but physical problems preclude, please state.",!!
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Prompt: "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",!!!!!!!!!!
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Prompt: $S($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):",!!!