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4 X 1 2 X 6 3

4 X 1 2 X 6 3
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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4 X 1 2 X 6 3Print 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. Ventanas Para Gavetas Gigantes Estibables De Pl stico 20 X 12 1 2 S CZ REDUKCJA 3 4X1 2 3 4x1 2 Systemy Instalacyjne Systemy Stalowe
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 Finolex Reducing FTA CPVC 3 4 x 1 2 Plumbing At Rs 22 piece In Pune
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 Simplify X 9 X X 5 X X 4 X X 0 X X 6 1 X 4 2 X 6 3 X 4 4 X MOS REDUKCJA 5 4X 1 2 5 4x1 2 Systemy Instalacyjne System Mosi ny
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