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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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Wake Up V1 V2 V3Print 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. Detail Contoh V1 V2 V3 Koleksi Nomer 17 HONDA BEAT V1 V2 V3 CLICK V1 125i 150i BRAKE PAD SET Lazada PH
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 Wake Past Simple Simple Past Tense Of Wake Past Participle V1 V2 V3
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