21 467p

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21 467p

21 467p

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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21 467pPrint 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. NEW Freightliner POL 21467P Neutral Switch FREE SHIPPING EBay Download 00FF00 Original Aiflowers 21 SVG FreePNGImg

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 Backup Lamp Switch 21 467P OEM Paccar Big Rig World

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 PFTL301E 0 5 KN PFTL301E 1 0 KN PFTL301E 2 0 KN ABB ESP8266 L298N Motor Drive Smartphone Arduino Project Hub 44 OFF