25m2 30m 9

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25m2 30m 9

25m2 30m 9

25m2 30m 9

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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25m2 30m 9Print 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. 107410824 1714996387628 gettyimages 2095063115 AFP 34M29L9 jpeg v Key Environmental Groups Endorse Biden Despite Fossil Fuel Approvals

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 Factorize The Following1 A2 8a 162 P2 10p 253 25m2 30m 94

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 Studio Vila Ol mpia Casa De Valentina 2 Factorise i 4p2 9q2 iiv 25m2 30m iv 49y2 84yz 36z2 vi 121b2

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