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Fetal Remains Tracking & Removal Form
Patient Name: ___MAN:___Address: ___ City/State: ___
Contact Number: ___
Attending Physician: ___OMI Case*? Yes Autopsy? Yes No Unknown yes, name of OMI Representative
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How to fill out patient label fetal remains
How to fill out patient label fetal remains
01
Obtain a patient label for fetal remains from the medical facility or healthcare provider.
02
Fill out the label with the patient's name, date of birth, and any other requested information.
03
Ensure the label is securely attached to the container holding the fetal remains.
Who needs patient label fetal remains?
01
Individuals who have experienced a pregnancy loss or termination and are arranging for the handling and disposal of fetal remains.
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What is patient label fetal remains?
Patient label fetal remains refers to the identification and labeling system used for fetal tissue or remains in a medical or clinical setting, ensuring proper handling and documentation.
Who is required to file patient label fetal remains?
Healthcare providers and facilities that handle fetal remains are required to file patient label fetal remains.
How to fill out patient label fetal remains?
To fill out the patient label fetal remains, you should include the patient's name, date of the procedure, type of procedure, and any relevant medical information related to the fetal remains.
What is the purpose of patient label fetal remains?
The purpose of patient label fetal remains is to ensure accurate identification, tracking, and respectful handling of fetal remains in compliance with legal and ethical standards.
What information must be reported on patient label fetal remains?
The information that must be reported includes the deceased person's name, date of birth, date of the procedure, type of fetal remains, and any pertinent medical history.
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