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8180 4

8180 4

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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8180 4Print 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. Defense Secretary Lloyd Austin Has Prostate Cancer 107285367 16917745592023 08 11t171122z 553364842 rc2sl2ax4jqv 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 107347267 17024943342023 12 13t184222z 1726334501 rc2hw4anbhxp rtrmadp

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 107202410 1677779234438 gettyimages 1176566250 AFP 1LJ4X0 jpeg v RBC Raises 2024 S P 500 Target Despite The Pullback To Start The Year