3 X 3 X 9 4x

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3 X 3 X 9 4x

3 X 3 X 9 4x

3 X 3 X 9 4x

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 X 3 X 9 4xPrint 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. Solve The Following Linear Equations 4 x y 3y 5 0 And 5x 2 x y 12 0 B i 3 Cho Bi u Th c P 3x 3 2 x x 3 x 3 X 9 B i 4 Cho Bi u Th c P

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 3x x 3 9 x 3 3x 2 27 x 2 9 YouTube

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 Solutions Manual X 2 X 1 2x 3 X 1

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