Dorman 924 370

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Dorman 924 370

Dorman 924 370

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

Cable De Cerradura De La Puerta Dorman 924 370

Dorman 924 370Print 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. AI Liu Yifei 8 370 Genshin Impact Image By RUKI Mangaka 3841242 Zerochan Anime Image

Doh 3474 pdf New York State Department of Health

Cable De Cerradura De La Puerta Dorman 924 370

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 AI 353 370

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 Hong Kong School Girl Large scale Body Private Photo Set 37 370 Hong Kong School Girl Large scale Body Private Photo Set 8 370