5 3x 2 10x

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5 3x 2 10x

5 3x 2 10x

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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5 3x 2 10xPrint 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. Solved 9 Multiply x 5 4x 8 12x 2 32x 16 1 Point 3x 2 4 x 3x 4x 7 5 3x 2 Brainly in

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 5 3x 5x 19 3x 3x 5 2x 19 19 19 24 24 2x 24 X 1 12

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 3x 2 10x 3 23 x 3x 2 5x 2 3x 4x 5 2x 1 Brainly in