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70000 Kb Ka Mb
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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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70000 Kb Ka MbPrint 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. Chousou Jujutsu Kaisen Image By NC9 4021215 Zerochan Anime Image Priestess Arknights Image By HyperGryph 3992391 Zerochan Anime
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 Velvet Hazbin Hotel Image By Koteikamello 3986643 Zerochan Anime
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 Bryophyta Arknights Image By Ggqqyygg 3989368 Zerochan Anime Matsumoto Rangiku BLEACH Image 4005986 Zerochan Anime Image Board
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