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Facility Worksheet for Oregon Fetal Death Certificate Word Version  Form

Facility Worksheet for Oregon Fetal Death Certificate Word Version Form

Use a oregon death report template to make your document workflow more streamlined.

Disposition permit can only be used for a fetal death. A planned induced termination of pregnancy is NOT a fetal death. FETUS Fetus Name First Date of Delivery Middle Last Suffix MM Time of Delivery / / DD YYYY Sex AM ☐ PM ☐ Military ☐ ☐ Male ☐ Female ☐ Undetermined METHOD OF DISPOSITION (Select one) Facility releasing fetus for Final Disposition; hospital must provide a disposition permit to any party transporting remains: Hospital released fetus to parents Hospital released fetus...
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