DVBCFSCK.m

DVBCFSCK ;ALB/GTS-557/THM-URETHRAL FISTULA ; 12/27/90  7:35 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,"# 0630 Worksheet" S HD7="URETHRAL OR BLADDER FISTULA (GU)",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,"Complications and/or medical side effects should always be",!?13,"reported, even when not specifically requested.",!!

 I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",!!!!!!!!!!

 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. Number and location of fistulae -",!!!!!

 D:'$D(CMBN) HD2 W ?8,"2. Drainage constant or intermittent -",!!!!!?8,"3. Constant use of pad or appliance -",!!!!!?8,"4. Frequency of pad changing -",!!!!!!!!!!

 W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!! D:$Y>50 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 "_NAME,!,HD8,!!!

 Q

 ;

SETIOF ;  ** Set device control var's

 D HOME^%ZIS

 Q

--- Routine Detail   --- with STRUCTURED ROUTINE LISTING ---DVBCFSCK   1682     printed  Apr 09, 2024@20:56:26                                                                                                                                                                                                    Page 2

DVBCFSCK  ;ALB/GTS-557/THM-URETHRAL FISTULA ; 12/27/90  7:35 AM

 +1       ;;2.7;AMIE;;Apr 10, 1995

 +2        SET PG=1

           SET HD91="Department of Veterans Affairs"

 +3        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,"# 0630 Worksheet"

           SET HD7="URETHRAL OR BLADDER FISTULA (GU)"

           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,"Complications and/or medical side effects should always be",!?13,"reported, even when not specifically requested.",!!

 +5        IF '$DATA(CMBN)

               WRITE "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",!!!!!!!!!!

 +6        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):",!!!

 +7        WRITE ?8,"1. Number and location of fistulae -",!!!!!

 +8        if '$DATA(CMBN)

               DO HD2

           WRITE ?8,"2. Drainage constant or intermittent -",!!!!!?8,"3. Constant use of pad or appliance -",!!!!!?8,"4. Frequency of pad changing -",!!!!!!!!!!

 +9        WRITE $SELECT($DATA(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!

           if $Y>50

               DO HD2

           WRITE $SELECT($DATA(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!

 +10       KILL LN,LN1,LN2

 +11       QUIT 

 +12      ;

HD2        SET PG=PG+1

           WRITE @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for "_NAME,!,HD8,!!!

 +1        QUIT 

 +2       ;

SETIOF    ;  ** Set device control var's

 +1        DO HOME^%ZIS

 +2        QUIT