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1 2 X 6 X 9 X 7

1 2 X 6 X 9 X 7

1 2 X 6 X 9 X 7

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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29050672

1 2 X 6 X 9 X 7Print 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. Factoring Algebraic Expressions Pdf Foto De Stock Gratuita Sobre Abrazar Abrazo Afecto

Doh 3474 pdf New York State Department of Health

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10288642

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 38815689

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 93 20359677 New Puppy Little Scared Stock Photo Image Of Furniture 235937904

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18471430

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11775147

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Carolina Wang Arte Elefante Arte Pintura Acrilica

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Vector Isometric City Residential Area Map

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13622305

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Ventanas Para Gavetas Gigantes Estibables De Pl stico 20 X 12 1 2 S

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01971427

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38815689

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Female Standing Stock Image Image Of Adult Standing 2479053

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Padre E Hijo Foto De Archivo Imagen De Junto Felicidad 47032724