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305 Lada

305 Lada

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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305 LadaPrint 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. Sango pok mon Pok mon Horizons The Series Image By Ukime05 Diabolik Lovers Haunted Dark Bridal Image By IDEA FACTORY 3745770

Doh 3474 pdf New York State Department of Health

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 Cure Rouge Natsuki Rin Image By Toei Animation 3965914 Zerochan

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 Sumeragi Sakuya CODE GEASS Dakkan No Roz Image By Sunrise Studio Uzumaki Naruto BORUTO Naruto Next Generations Wallpaper By