Adequacy of the VA Persian Gulf Registry and Uniform Case Assessment Protocol (1998) / Chapter Skim
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Appendix H: Persian Gulf Registry Code Sheet
Appendix H: Persian Gulf Registry Code Sheet
Pages 123-134
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From page 123... ...
Appendix H Persian Gulf Registry Code Sheet 123
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From page 124... ...
1 ~en InO.stn or Al~ban Nat~e' 3~eck, Not d Hi~c Or~rt ~ Ht~sente 2~.n or P - k l~r 4 Wnitet, Net of Hl~c Oript "Unb~own 124 ADEQUACYOFTHE VA PERSIAN GULFREGISTRY AND UCAP PERSIAN GULF REGISTRY CODE SHEET ~ ~ ~_ Ule IDIOnn~OO the vekrut ·upplie~t r~ety be di~tclo~od outside the VA to Fedaal, St k and h~l pVCaDmCDt egonc~t etDd N.tioDal Health Oreg~n;~rioo~t to a4ut r~ tht devdoprnertt o, p f rtue~ch pU~pOBUt u~d r~her WClt Jlt ~tatod in tbe 'Notice of Sy~tt~ ~ of VA Record~t- pctblishod ID the Fodenl Register Ut ~r~Ce V~;tD t~ Priv~ Act of 1974 t or INSTRUCTIONS: Ple~e p~tt. Uee or~ly oDe htkr or sumber per blocL lf poutibh usc bistcic bellporDt or fat-tip p~ Sh~d ueae for VA use or~ly.
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From page 131... ...
U: NONE, LEAVE BLANK DESCRIIBE DlAONOSES (Nul~)
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From page 133... ...
AFTER COMPLETING PHASE II, UNIFORM CASE ASSESSMENT PROTOCOL, THE PHYSICIAN FEELS THAT THE VETE RAW "S ~ N UNEXPLAINED ILLNF~c? (Enter cotb In bbctt 248)
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