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Fill and Sign the Uniform Anatomical Gift Act Donation Generic Poa 203

Fill and Sign the Uniform Anatomical Gift Act Donation Generic Poa 203

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ANATOMICAL GIFT FORM In the event of my death, I donate the following part(s) of my body for the purposes identified in AS 13.52.170:Tissue:__________________________Eyes:__________________________ Bone and connective tissue: __________________________Skin:__________________________Heart:__________________________Other:__________________________Limitations: __________________________Organ: __________________________Heart:__________________________Kidney(s): __________________________Liver:__________________________Lung(s): __________________________Pancreas Other: __________________________I designate __________________________ (name of surgeon or physician) to carry out the appropriate procedure(s) for removing or transplanting the body part(s) identified above. ________________________________ Signature AK-02010

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How to Sign a PDF on iPhone How to Sign a PDF on iPhone

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How to Sign a PDF on Android How to Sign a PDF on Android

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