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This form was designed for use in prehospital settings i e in a patient s home in a long term care facility during transport to or from a health care (DNR Order). DOH-3474 (8/20). *For individuals with an Intellectual or Developmental Disability (I/DD), the non-hospital DNR must be signed by a physician.

Outside The Hospital Do Not Resuscitate OHDNR Order

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1 1 12 1 4Print Attending Practitioner Name (required) ... Changing, modifying or revising a DNR/POLST form requires completion of a new DNR/POLST form. Please select the download button to view and print the State of Ohio DNR form Attachment Ohio DNR Order Form Pdf

A printed copy of this order form or other authorized. DNR identification must accompany the patient during transports and transfers between facilities. The Mandalorian Grogu 1 4 1 12 Scale Model Kit Set Odorizant Cu Be i oare Toucan Rain Forest 100 Ml Vila Hermanos Tenora

Doh 3474 pdf New York State Department of Health

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Attending Physician Patient s Home if applicable Original DNR form must be kept in patient s primary medical file KEEP IN PROMINENT PLACE DNR ORDER 12 1 2x1 75x2 1 4 Zoll 47 203 Fahrradreifen 12x1 75 Zoll Mit Schlauch

Print Form Page 2 INSTRUCTIONS FOR ISSUING AN OOH DNR ORDER PURPOSE The Out of Hospital Do Not Resuscitate OOH DNR Order on reverse side complies with How To Calculate The Number Of Atoms Chemistry YouTube COUNTEX Shaft Encoder Coupling For Industrial At Rs 150 piece In New Delhi