3 2 X 2 1

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3 2 X 2 1

3 2 X 2 1

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

F x x 2 3 x 2 3 x 2 1 Oldu una G re F 3 2 1 Ka t r

3 2 X 2 1Print 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. Photo 2x2 Inch About 1 MB In Size Size Tool Requirements Evaluate Each Rational Expression For The Given Value Of X 2 x 2

Doh 3474 pdf New York State Department of Health

X 2 3 x 1 2 x 3 Cevab Nedir 2x 1 4 x 4 3 Cevab Nedir 2 x 3 5 1 10

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 Graphic 3 2x

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 Xy 2 x 2 1 yx 2 y 2 1 x 2y 2 x y Simply The Following Expression Solve 3 x 3 2 X 1 5 X 5 And Check The Result Brainly in