14 5n 4 17

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14 5n 4 17

14 5n 4 17

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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14 5n 4 17Print 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. Exxon CEO Dismisses Worries FTC Could Hold Up Pioneer Deal 108016285 1722871078618 gettyimages 2165248084 0d2a8928 xkjc4pi9 jpeg v

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 Satin Hair Color 5n Developer Hair Developer 20 Volume Hair Hair Color

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 Mink Hair Grows For IPhone Download 107343976 17018781752023 12 06t155206z 1560467129 rc2rr4ai5xle rtrmadp