5mm X 20mm 5 Amp Fuse

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5mm X 20mm 5 Amp Fuse

5mm X 20mm 5 Amp Fuse

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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5mm X 20mm 5 Amp FusePrint 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. 10Pcs M205 Ceramic Fuse 5mm X 20mm Fast Blow 250V Select From 0 1A 100Pcs Box 2A 250V Fuses 2 Amp Fast Blow Fuse 5mm X 20mm F2AL250V Glass

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 X 20mm Glass Fuse 250V 10A

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 20Pcs M205 Glass Fuse 5mm X 20mm Slow Blow 250V Select From 0 5A To 5mm X 20mm 250V Quick Acting Ceramic Fuses Tube Fast Blow On All Orders