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40 6x2 2 4 6
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40 6x2 2 4 6
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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40 6x2 2 4 6Print 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. ETS2 1 46 ADDON SCANIA NEXT GEN HOLLAND STYLE SIDESKIRT 4x2 6alpha 2 4 6 cycloheptatrienyl 17beta hydroxy 4 androsten 3 one 29977
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 6 Scania G540 B 6x4 4HA M ller Transport AG Dietikon
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 Battery Operated Landscape Irrigation Controller For 2 4 Or 6 Stations SAFE Act

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