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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 Mb Into MbpsPrint 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. 108022744 1724155359733 gettyimages 458905660 UK MIKE LYNCH jpeg v 107306630 1695736713637 gettyimages 1603139726 AA 17082023 1310411 jpeg
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 107381172 1709313812244 gettyimages 1930144970 DAVOS WEF 2024 jpeg v
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 107407991 1714471860028 gettyimages 2139242382 HK HSBC SUMMIT jpeg v Palo Alto Networks PANW Earnings Report Q4 2023
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