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195 55 R15 Yokohama

195 55 R15 Yokohama

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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195 55 R15 YokohamaPrint 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. Kit 04 Pneus 195 55 R 15 Advan Neova 85v Yokohama PNEURODA YOKOHAMA ADVAN A052 195 50R15

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 Pneu 315 75R16 Yokohama G001 M T MUD 113Q

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 Off road Tire Extra Trak 195 80 R15 Italian Company Pneus Ovada Yokohama S Drive High Performance Tire 195 50R15 82V Walmart