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6 3 180 Lb
6 3 180 Lb
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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6 3 180 LbPrint 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. YouTube F 28 5 4 180lbs 133lbs 47lbs 1 Year Losing With Chronic
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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 11 180 Lbs Should I Cut Or Continue To Lean Bulk with Pics
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 23 5 8 180 150 30 Lbs 3 Years All It Took Was A Lifestyle Change Man Documents His Weight Loss Journey From 202 Lbs To 160
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