Prompt: !?25,HD91,!?22,"Compensation and Pension Examination",!
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Prompt: ?33,"# 1315 Worksheet"
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Prompt: ?33,"# 1315 Worksheet"
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Prompt: !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
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Prompt: !!!!,"Narrative:",?13,"Report both functional and cosmetic impairment.",!!
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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):",!!!
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Prompt: ?8,"1. External nose -",!!!!!?8,"2. Nasal vestibule -",!!!!!?8,"3. Right and left nasal cavities -",!!!!!
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Prompt: ?11,"a. Septum -",!!!?10," b. Floor of the nose -",!!!!?9," c. Inferior meatus -",!!!!
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Prompt: ?10," d. Inferior turbinates -",!!!!?10," e. The middle meati -",!!!!?10," f. The middle turbinate -",!!!!
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Prompt: ?10," g. The spheno-ethmoidal recess -",!!!!?10," h. The olfactory area -",!!!!?10," i. The superior turbinates -",!!!!!!
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Prompt: ?8,"4. The paranasal sinuses- ",!!!!!!
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Prompt: $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!