5 6 128 Lbs

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5 6 128 Lbs

5 6 128 Lbs

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

Introduction Cutting Female 27 5 0 128 Lbs R BTFC

5 6 128 LbsPrint 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. F 26 5 4 160 Lbs 128 Lbs 32 Lbs Officially Hit My Goal Weight ETF

Doh 3474 pdf New York State Department of Health

200 Lbs In Kg

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 F 21 5 6 184 128 56 Lbs Posted On Here A Little While Ago About

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 F 37 5 6 200 Lbs 130 Lbs 70 Lbs 13 Months Tiny Habit Changes Updated Nikkor Z 70 180mm F 2 8 180 600mm F 5 6 6 3 VR Pre order