3 0 X 2 0

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3 0 X 2 0

3 0 X 2 0

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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3 0 X 2 0Print 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. OBUDOWA LOGIC J23 USB 3 0 X 2 BLACK x 2 x 4x 3 0 x 2 r 3 x 4 0 x 2 2 x 3 4 x 4

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 JUMPER Ordenador Port til 13 3 Pulgadas 1920 1080 IPS FullHD 4GB

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 MUSETEX Mid Tower ATX PC Case With 6 X 120 Mm ARGB Fans Mesh Computer 4327017 Cummins Temperature Switch Source One Parts Center