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DELIVERY ROOM DEATH FORM FOR INFANTS BORN IN 20221DO NOT mail or fax this form to the CCC Data Center. This form is for internal use ONLY.NETWORK ID:HOSPITAL ID:Any inborn infant who dies in the delivery
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Visit the website of the delivery room death online form.
02
Provide your personal information, such as your name, contact details, and address.
03
Specify the details of the deceased, including their name, age, and cause of death.
04
Enter the time and location of the death.
05
Upload any necessary documents, such as medical records or death certificate.
06
Review the information provided and make sure all details are accurate.
07
Submit the online form.
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Wait for confirmation or further instructions from the delivery room death department.

Who needs online delivery room death?

01
Individuals who have experienced the death of a loved one at a delivery room.
02
Family members or legal representatives responsible for handling the deceased's affairs.
03
Any relevant authorities or organizations requiring documentation of the death.
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Online delivery room death refers to the reporting of a newborn infant who passes away in the delivery room.
Healthcare professionals present during the delivery room death are required to file the report online.
The online form for reporting delivery room death typically requires information about the newborn, the circumstances of the death, and contact details of the healthcare professionals involved.
The purpose of online delivery room death reporting is to track and monitor infant mortality rates and improve healthcare practices.
Information such as the date and time of death, cause of death, newborn's details, and healthcare professionals' details must be reported.
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