File:The MOLST Form.JPG

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current19:12, 9 December 2010Thumbnail for version as of 19:12, 9 December 20101,728 × 3,072 (942 KB)commons>ISTJonathan{{Information |Description={{en|1=The New York State Department of Health MOLST form (DOH-5003)}} |Source=I took this picture of a New York State Department of Health form |Author=Jonathan Karmel |Date=December 9, 2010 |Permission= |other_versions= }}

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