Subway 6862 0

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Subway 6862 0

Subway 6862 0

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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Subway 6862 0Print 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. 108002514 17204392452024 07 07t203520z 1456554534 rc2kq8at0ip2 rtrmadp 107229367 1682096267592 gettyimages 1483885619 m010495 l0yucji6 jpeg v

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 Subway Hands Holding Subway Sandwich Hand Food PNG Transparent

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 Subway Free Coloring Page Download Print Or Color Online For Free SUBWAY PAY CONFI VEL NOVA PLATAFORMA DO SUBWAY PAY SUBWAY SURFERS