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X 2 8x 52
X 2 8x 52
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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X 2 8x 52Print 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. King charles 012624 2 9cd6206f354d4e72bce30af1bb8b91af jpg STRUCTURAL 2 In X 3 In X 8 Ft Actual Dimensions 1 1 2 In X 2 1 2 In
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 3x 2 Y 9x 2 Y 2 5 2 2y 2 8x Brainly in
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 Show How To Solve 2x 2 8x 10 By Factoring Brainly Simplify x 1 x 2 3x 2 x 2 x 2 5x 6 x 5 x 2 8x 15
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