50 Dkg U Grame

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50 Dkg U Grame

50 Dkg U Grame

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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50 Dkg U GramePrint 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. 107118308 1663156354351 gettyimages 1243214676 AFP 32JC79U jpeg v 108039906 17273840622024 09 26t204605z 515391438 rc2k8aa1u07m rtrmadp 0

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 108022259 17240904262024 08 19t175033z 501754141 rc20j9ap4u2e rtrmadp 0

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 Costco 107427150 1718111859426 gettyimages 2154386464 AFP 34U62VE jpeg v