3x 4 2 3x 5 2x 5

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3x 4 2 3x 5 2x 5

3x 4 2 3x 5 2x 5

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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3x 4 2 3x 5 2x 5Print 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. 1 6x 7x 2 3x 8x 3 3x 4x 6x 2x 4 X 3x 8x 3x 5 X Como Resolver Esta Ecuaci n 2 2x 5 5x 2 3x Y 3x 2x 5 5x 3x Y

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 L m 4x 3 2x 2 x 3x 2 2x Cuando X Tiende A 0 L MITE De Una Funci n

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 2x 1 6x 3 7x 1 0 5 2x 3x 1 6 5x 0 4x 3 2x 7 7x 2 0 3x 2 5x 2x 3 3x 1 2x 3 3x 4 Brainly in