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Y 3 4 2 5

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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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Y 3 4 2 5Print 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. Clase 2 Ddhh Clase 2 Derecho Internacional De Los Derechos Humanos SUCESO Cable Adaptador Jack Hembra 3 5mm A Jack Doble Macho Para

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 Arizona Lottery Mega Millions Pick 3 Results For July 5 2024

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 CIS 2 3 EPOXYBUTANE 1758 33 4 1H NMR Spectrum Red Hot Reboot 2024 Country Pride Dance Club