WV REFUSAL-DISPLAY-1 (263)    BLOCK (.404)

Name Value
NAME WV REFUSAL-DISPLAY-1
DATA DICTIONARY NUMBER 790.1
FIELD
  • FIELD ORDER:   1
    CAPTION:   * * * ADD/EDIT A REFUSAL * * *
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   1,22
  • FIELD ORDER:   6.5
    CAPTION:   Br Tx Fac:
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   6,50
  • FIELD ORDER:   2.2
    CAPTION:   !M
    EXECUTABLE CAPTION:   S Y=IOINHI_$$NAME^WVUTL1(WVDFN)_"("_$$AGE^WVUTL1(WVDFN)_")"_IOINORM
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   3,15
  • FIELD ORDER:   3.2
    CAPTION:   !M
    EXECUTABLE CAPTION:   S Y=IOINHI_$$CMGR^WVUTL1(WVDFN)_IOINORM
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   4,15
  • FIELD ORDER:   5.3
    CAPTION:   Cx Tx Need :
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   5,1
  • FIELD ORDER:   5.4
    CAPTION:   !M
    EXECUTABLE CAPTION:   S Y=IOINHI_$$CNEED^WVUTL1(WVDFN,1)_IOINORM
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   5,15
  • FIELD ORDER:   4.3
    CAPTION:   !M
    EXECUTABLE CAPTION:   S Y=IOINHI_$$PAPRG^WVUTL1(WVDFN,1)_IOINORM
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   4,61
  • FIELD ORDER:   2
    CAPTION:   Patient Name:
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   3,1
  • FIELD ORDER:   2.8
    CAPTION:   !M
    EXECUTABLE CAPTION:   S Y=IOINHI_$$SSN^WVUTL1(WVDFN)_IOINORM
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   3,61
  • FIELD ORDER:   6.4
    CAPTION:   !M
    EXECUTABLE CAPTION:   S Y=IOINHI_$$BNEED^WVUTL1(WVDFN,1)_IOINORM
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   6,15
  • FIELD ORDER:   20
    CAPTION:   --------------------------------------------------------------------------------
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   10,1
  • FIELD ORDER:   19
    CAPTION:   !M
    EXECUTABLE CAPTION:   S Y=$$EDC^WVUTL1(WVDFN)
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   9,1
  • FIELD ORDER:   17
    CAPTION:   !M
    EXECUTABLE CAPTION:   S Y=IOINHI_$S($$DES^WVUTL1(WVDFN)="YES":"*DES DAUGHTER*",1:"")
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   9,61
  • FIELD ORDER:   21
    CAPTION:   !M
    EXECUTABLE CAPTION:   S Y=IOINHI_$$FACIL^WVUTL1A(WVDFN,"C")_IOINORM
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   5,61
  • FIELD ORDER:   22
    CAPTION:   !M
    EXECUTABLE CAPTION:   S Y=IOINHI_$$FACIL^WVUTL1A(WVDFN,"B")_IOINORM
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   6,61
  • FIELD ORDER:   23
    CAPTION:   MST :
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   8,1
  • FIELD ORDER:   3
    CAPTION:   Case Manager:
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   4,1
  • FIELD ORDER:   24
    CAPTION:   !M
    EXECUTABLE CAPTION:   S Y=IOINHI_$$MST^WVUTL1A(WVDFN)_IOINORM
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   8,15
  • FIELD ORDER:   25
    CAPTION:   Veteran:
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   7,52
  • FIELD ORDER:   26
    CAPTION:   !M
    EXECUTABLE CAPTION:   S Y=IOINHI_$$VET^WVUTL1A(WVDFN)_IOINORM
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   7,61
  • FIELD ORDER:   27
    CAPTION:   Elig Code :
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   7,1
  • FIELD ORDER:   28
    CAPTION:   !M
    EXECUTABLE CAPTION:   S Y=IOINHI_$P($$ELIG^WVUTL9(WVDFN),U,2)_IOINORM
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   7,15
  • FIELD ORDER:   23.1
    CAPTION:   CST:
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   8,56
  • FIELD ORDER:   23.2
    CAPTION:   !M
    EXECUTABLE CAPTION:   S Y=IOINHI_$$CST^WVUTL1A(WVDFN)_IOINORM
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   8,61
  • FIELD ORDER:   5
    CAPTION:   !M
    EXECUTABLE CAPTION:   S Y="PAP Regimen:"
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   4,48
  • FIELD ORDER:   6
    CAPTION:   Br Tx Need :
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   6,1
  • FIELD ORDER:   2.5
    CAPTION:   SSN:
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   3,56
  • FIELD ORDER:   4.5
    CAPTION:   Cx Tx Fac:
    FIELD TYPE:   CAPTION ONLY
    CAPTION COORDINATE:   5,50