rn pronouncement of death form massachusetts

Bell, K. W. (2010).Living at the end of life: A hospice nurse addresses the most common questions. Miller, J. E., & Cutshall, S. C. (2001).The art of being a healing presence: A guide for those in caring relationships. Has 7 years experience. and The National Hospice and Palliative Care Organization (NHPCO.) Please let us know how we can improve this page. Called to room by CNA at 4pm and noted resident without pulse, respirations or BP. endobj When a patient dies in a licensed hospice or a nursing home in the absence of a physician and under specific circumstances, that person may be pronounced dead as provided by law in GA Code Ann, 31-7-16 and . The value-added of EDELE is that the directly to tabular, graphic or narrative data. We will update and add resources on a continuing basis. National Hospice and Palliative Care Organization Body released to MacVille Funeral Home. Any person found dead (For complete list, see Pronouncement of Death Fact Book, 1999, page 13 . %PDF-1.7 % endstream Sudbury, Mass: Jones and Bartlett. $,et&; 0000006264 00000 n x]O8Lc;NVawXj/\q'I9v!%4|f:b 9>&zIit(0~c]99]L/a,VuyBdO|%"Z)smh S WsB ( sFg;fEe=RAEv-T);~1Z_F mg|!d}o4- it,: !m`M)HjMrl! If your complaint is not resolved by your hospice team, or if you feel uncomfortable discussing it with them, you should contact the administrator of your hospice. %PDF-1.5 ongoing education that they can access twenty four hours a day, at home What would you include in a nurse's note for an RNdeath pronouncement? ongoing education that they can access twenty four hours a day, at home &)e? yPK-1[Hf| `6krIl6`b|`}'c+-&*'`A0a)W~F\AMc%uE!cs+U,eicN'$]^he[@leShx cW. +SSB{G:Z Khr>@Nr9VoXIw]&+8PVNe&^/{'+FySkgU[8lZ4.B-btb5`N5qja1 +S5P*_0 H`?@q%G;=v)/HXDX% |aG-wKK23cRoQb~f_Aw% c x-H{`0lx,(G,:A:yiIT! PallipediaA free online palliative care dictionary to be built by the international community, under the auspices of IAHPC. Notifies the MRP / RN(EC) of the patient's death, noting date and time of death, receiving funeral home Telephone: 305-538-9272, Hospice and Palliative Nurses Association !4320hpS2 Z a Keep in mind . Please limit your input to 500 characters. 11 0 obj endobj It provides a forum for members to engage in cross-continuum collaboration to address regulatory and clinical barriers that impede caregivers vital work. Growth House: Guide to Death, Dying, Grief, Bereavement, and End-of-Life Resources Good answer? The 0000001931 00000 n If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. CPR, Artificial Feeding, Comfort Care, and the Patient with a A comprehensive resource guide and directory of end-of-life care resources and services available throughout Massachusetts. See the. Contact the physician at the time of death - that death has occurred and where body will be taken. allows the RN to determine and pronounce death. George Washington Institute for Spirituality and Health hbbd```b``Y "W`r5dXM The Continuum of Care Council (CCC) is an advisory council of the Massachusetts Health & Hospital Association (MHA), established with the goals to optimize patient care, experiences, and clinical and economic outcomes through population health strategies. 316 0 obj <>stream (b) "Pronouncement of Death" is the declaration by the registered nurse who has made the determination of death. Employers should access assistance form legal services to consider . Complete Pronouncement Of Death Form in just several minutes by using the instructions below: Find the document template you require from our library of legal forms. When a Mesothelioma Survival Information provides detailed information on Mesothelioma and the ways various treatments can improve the lives of patients. endobj trailer << /Size 39 /Info 15 0 R /Root 18 0 R /Prev 119813 /ID[] >> startxref 0 %%EOF 18 0 obj << /Type /Catalog /Pages 14 0 R /Metadata 16 0 R /PageLabels 13 0 R >> endobj 37 0 obj << /S 108 /L 181 /Filter /FlateDecode /Length 38 0 R >> stream <> Resident found unresponsive; Absence of P/R/BP. For lists of online, searchable catalogue of data about care at the end of life. Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. 0000058024 00000 n An award-winning gateway to resources for life-threatening illness and end-of-life issues. Death is a very serious thing to announce legally and there are a lot of consequences for doing it. (Effective August 2, 1994) Sec. Jones, L., Mack, C., Generations Together., Video Difference, Inc., & University of Pittsburgh. Massachusetts laws MGL c.30A, 14 Judicial review Have forms and black pens with you. is Hospice, we notify Hospice, also. Learning to say goodbye. Overnight Shelters; Veterans Shelters; Food Pantries; Women and Children; Male Shelters; Hot Meals National Hospice & Palliative Care Organization A nursing organization of over 9,200 members dedicated to promoting excellence in End-of-Life nursing Innovations in End-of-Life Care An international, online journal, committed to more humane, comprehensive, and coordinated care for dying persons and their families. 0000002389 00000 n 7 0 obj 1-612-816-8773. MHA and its Continuum of Care Council would like to acknowledge the many clinicians, partners, and organizations that contributed to the creation of this guide. Only Sections 1431 and items 46 are- to be completed by the R egistered Nurse according to the instructions on the back of the form. endobj For your convenience, we have provided a number of links to valuable services and helpful information. If your complaint is not resolved by your hospice team, or if you feel uncomfortable discussing it with them, you should contact the administrator of your hospice. Telephone: 617-618-2185 Wogrin, C. (2001).Matters of life and death: Finding the words to say goodbye. http://smhs.gwu.edu/gwish/about/contact. (2010).Ten thousand joys & ten thousand sorrows: A couple's journey through Alzheimer's. 8 0 obj xbbbd`b``` V ` ), Tuesdays with Morrie: An old man, a young man, and life's greatest lesson, Close to the bone: Life-threatening illness and the search for meaning, The fall of Freddie the leaf: A story of life for all ages, Dying well: Peace and possibilities at the end of life, Final gifts: Understanding the special awareness, needs, and communications of the dying, Final journeys: A practical guide for bringing care and comfort at the end of life, Lessons for the living: Stories of forgiveness, gratitude, and courage at the end of life, Ten thousand joys & ten thousand sorrows: A couple's journey through Alzheimer's, Midwife for souls: Spiritual care for the dying, The art of death midwifery: An introduction and beginner's guide, Waterbugs And Dragonflies: Explaining Death To Young Children, Matters of life and death: Finding the words to say goodbye, Living at the end of life: A hospice nurse addresses the most common questions, Hospice and palliative care: The essential guide, Scope and standards of hospice and palliative nursing practice, The art of being a healing presence: A guide for those in caring relationships, Hospice and palliative care: Concepts and practice, Grief counseling and grief therapy: A handbook for the mental health practitioner, Symptom management algorithms: A handbook for palliative care, Living with dying: A guide for relatives & friends, Being a compassionate companion: A series, After the Hospital: A Guide to Post Acute Care, Guide to Help Palliative CarePrograms Successfully Complete, End of Life Palliative Educational Resource Center, pidemiology of Dying & End-of-Life Experience, Growth House: Guide to Death, Dying, Grief, Bereavement, and End-of-Life Resources, Hospice and Palliative Nurses Association, Know Your Choices: A Guide for Patients with Serious Advancing Illness, Massachusetts Commission on End of Life Care, Massachusetts Compassionate Care Coalition, National Hospice & Palliative Care Organization, http://oig.hhs.gov/authorities/docs/hospicx.pdf, http://dhi.health.state.nm.us/elibrary/hflcregs/Appendix%20M.pdf, Charting for the Jury: Fine - Tune Documentation for Hospice & Home Care. Worden, J. W. (1996).Children and grief: When a parent dies. New York: Routledge. MD notified. j$7jH0yVvea^P(?}q14(( 0000083688 00000 n t21cKW%qD+8"alaC0`. (Effective October 20, 1988.) Maine, Texas, and New York are three states that allow the licensed RN the ability to pronounce death. Watson, M. S. (2005).Oxford handbook of palliative care. Section 45. 3. Suggestions are presented as an open option list only when they are available. New York: Riverhead Books. Know Your Choices: A Guide for Patients with Serious Advancing Illness A guide to enable patients or their advocates to make informed decisions about health care choices that reflect each person's goals, values, wishes and needs; outlining the types of choices that patients have when they are going through treatment for a serious life-limiting illness. endstream endobj 408 0 obj <. Information and legal advance directive instruments for all states are available at: New York, N.Y: Bantam Books. lol. 7-62-2. 0000003397 00000 n for physicians, nurses and other health care professionals. An international, online journal, committed to more humane, comprehensive, and coordinated care for dying persons and their families. (2009).Lessons for the living: Stories of forgiveness, gratitude, and courage at the end of life. problems." By this statute an RN has the authority to make an assessment and therefore, a determination of death. Marina del Rey, Calif: DeVorss Publications. Call placed to DR Jones. Pediatric Palliative Care Network (PPCN) [" ]-X#=@.>9,Do|rK. Aging With Dignity pupils fixed. An RN's assessment or determinant of death does not include the medical certification of death. New York: Macmillan. 3 0 obj endobj 315 0 obj <>/Filter/FlateDecode/ID[<630456F5BA98A44A83E4D585DBE64A93>]/Index[230 158]/Info 229 0 R/Length 185/Prev 113462/Root 231 0 R/Size 388/Type/XRef/W[1 3 1]>>stream (1997).Waterbugs And Dragonflies: Explaining Death To Young Children. 0000005727 00000 n I had to call the doc to come pronounce. )^%b9MND? Q@'+xUBgY*Hu`]sh1\Hp~|$g',%qB-,9QHU[ 6X=TsQ zDo|*)@KJyRHw1!-J\q|%cC&p,!lLI_)2<3.3K4*M&:{]MI.pK+ +w)g@?pf&'piS7b>RRS}kdiuJJM gDG?7!Ke8Vu m9JtQkyzU Remen, R. N. (1996).Kitchen table wisdom: Stories that heal. : BookSurge. Honoring Choices Massachusetts is a consumer focused non-profit organization supporting the right of every adult to direct their health care choices. This page is located more than 3 levels deep within a topic. Uo`0 t-yHC#[yJ/a0>LCkkwQ.p6\FuAIu8M[EE. New York: Riverhead Books. 705 0 obj <>stream 407 0 obj <> endobj <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 17 0 R/Group<>/Tabs/S/StructParents 1>> hb```f``:b@aeW@>dGi"s8Xf bpM@P6A,x &M2oCx(K7$10a.a[xCD42pwJ30:l# /'- 0000058102 00000 n Sign In Forever Sunshine, ASN, RN 1,261 Posts Specializes in LTC. Hospice Foundation of America Callanan, M. (2008).Final journeys: A practical guide for bringing care and comfort at the end of life. 0000001138 00000 n Specializes in Med nurse in med-surg., float, HH, and PDN. One also has to know the difference between death and the other states that an individual might be in at the time. In the rare event that your complaint remains unresolved, you may contact the Hospice & Palliative Care Federation of Massachusetts or the Department of Public Health's Patient Protection Line. MD is unable to come to facility at this time. Kalina, K. (2007).Midwife for souls: Spiritual care for the dying. When death occurs, the family follows the plan by: Contacting the nursing provider OR Contacting the Physician or RN(EC) to pronounce death B. Pronouncement of Death Nurse: Visits to pronounce death and support the family. endstream endobj startxref An A lock icon ( Overview "Legal forms" are forms that are not filed in court, such as forms for taxes, contracts, wills, and the like. m Top-requested sites to log in to services provided by the state. Resources, hospice locator guide, education opportunities, and general hospice information. Has 30 years experience. Share sensitive information only on official, secure websites. stream (1996).Hospice and palliative care: Concepts and practice. deceased and the date and time of death, and shall sign the death certificate. I never understood the rationale of taking bp. New York: Guilford Press. End of Life Palliative Educational Resource Center 272 0 obj <> endobj for Nursing Services, or Chief Nurse Executive is responsible for ensuring that designated RNs, APRNs, and PA's covered by this policy are trained and competent in the procedures necessary to assess and pronounce a CLC resident's death in circumstances allowed herein. Determination of prognosis by physician %PDF-1.6 % Specializes in LTC, rehab. Form R-360 07012014. Body released to MacVille Funeral Home. 15 0 obj 0 <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> an e-learning course that is appropriate for your hospice staff's endstream endobj 273 0 obj <>/Metadata 23 0 R/PageLabels 266 0 R/PageMode/UseOutlines/Pages 270 0 R/StructTreeRoot 44 0 R/Type/Catalog/ViewerPreferences 292 0 R>> endobj 274 0 obj <>/MediaBox[0 0 612 792]/Parent 270 0 R/Resources<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 275 0 obj <>stream S.l. 7-62-3. <> course/clerkship directors, residency and continuing education program The Hospice Education Network (HEN) New Hampshire patients the form completed for the pronouncement of death is the Certificate of Death. Local Homeless Services: If pt. You have the right to register a complaint with any hospice provider. %W`RR6`4,2A2b:, sa3Xf G\"@l-ltx%@vm 8 ] AMU6*0C;y PM1@"hTMIj6XP)2V]ptf1CYPkhj.| 7$;D&^MH5y]2bD@.Hv0@2aLfpa#jC}&.XT,lK2BZR/\t2 WBRaHNZ@n.ly!1D)m=bY@dHY6 Mm(SojN9UJRG5 ' eWMDaDo9p8QV*[fA c^ OsNx Fort Wayne, IN: Willowgreen Pub. 17 0 obj George Washington Institute for Spirituality and Health. After the Hospital: A Guide to Post Acute CareThe Continuum of Care Council (CCC) is an advisory council of the Massachusetts Health & Hospital Association (MHA), established with the goals to optimize patient care, experiences, and clinical and economic outcomes through population health strategies. Role of the LVN . The Trial Court Law Libraries have compiled this list of Massachusetts legal forms available online for no charge. endobj xXn8}GHiQuZYt6>}%Vw. : Video Difference, Inc. Kubler-Ross, E. (1969).On death and dying. experience of end of life. Massachusetts Legal Forms by Subject The Trial Court Law Libraries have compiled this list of Massachusetts legal forms available online for no charge. For Massachusetts patients, the form for pronouncement of death is the Pronouncement of Death Form by the Registry of Vital Records and Statistics in the Commonwealth of Massachusetts. an e-learning course that is appropriate for your hospice staff's \FOs{uhyfL /]B$,:~Qn/Q`eO|R|Yj8rzF#3=|/NUwjXy$U eAtM-"YnX:/ It provides a forum for members to engage in cross-continuum collaboration to address regulatory and clinical barriers that impede caregivers vital work. Charleston, S.C.? Telephone: 617-618-2185. Family at bedside. endobj This Pt is DNR. http://www.homelesshope.net/ 436 0 obj <>stream MK=l6SUQK>SHMX5iIm5Q7aY.nM WYS"J:thFVveCS.1BcFz|eh;qdNJ.[N:d#7P!,lhBSH*E,%fyZO]Z6ypCO{-5~28 &0(0jlGDCG.87|372/ QX 8^ Death associated with diagnostic/therapeutic procedure 5. 0000001484 00000 n Boston: Trumpeter. bQ7cB86 8x#8 ]2C A .mass.gov website belongs to an official government organization in Massachusetts. Has 7 years experience. hb```S,l Center to Advance Palliative Care:prepared byThe Joint Commission (TJC)Certification Process, DPH Forms - Death Pronouncement Guidelines for Burial or Cremation without a Funeral Director Caring for your own dead can be immensely rewarding and help ease the pain of grief. New York, N.Y: Bantam Books. Resident assessed, BP/P/R absent, Pupils fixed. @a2!lL}N,* bGF7p)ko,_)&$3SS(@Y^}%{vw9sh 4 0 obj <> Garden City, N.Y: Anchor Press/Doubleday. It 0 <> hbbd``b`fS3uSADT BDi0qA@ a$L@ HUX IF YES, DATE (Month DD, YYYY) Please remove any contact information or personal data from your feedback. [05q&7{b" http://www.healthcareproxy.org/, Massachusetts MOLST Massachusetts Medical Orders for Life Sustaining Treatment. YC" #OX] %%EOF Family, MD, Admin., and DON notified. Create well-written care plans that meets your patient's health goals. Death of any child under the age of 18 years from any cause 7. Buscaglia, L. F. (2002).The fall of Freddie the leaf: A story of life for all ages. if you don't have a pulse, then isn't taking a bp redundant? Clearly, the pronouncement of an individual's death is a significant obligation and it must be carried out with grace, respect and a concern for the family of the deceased. }C 8Cm1ioLsn[1~,AJWk;qoo8gn .q~DcAo7.'?no>=x A`-e@ Oxford: Oxford University Press. Johnson, S. (1984).The precious present. 290 0 obj <>/Filter/FlateDecode/ID[<62DBEB941E88F1428ACE081799A7268D>]/Index[272 45]/Info 271 0 R/Length 86/Prev 157303/Root 273 0 R/Size 317/Type/XRef/W[1 2 1]>>stream The pronouncement of death form should be completed by every person pronouncing the decedent at the facility and a copy should be given . Massachusetts Medical Society endstream endobj 231 0 obj <. who are (or will be) involved in providing EOL instruction to health Guidelines 6 c. removing any medical equipment or drains (except for autopsy cases); d. assisting with any postmortem tissue or sample procurement; and e. assisting with processes for organ or tissue transplantation. ) or https:// means youve safely connected to the official website. endobj Chapter 3, Article 1 3.1.18, Registered Nurse Pronouncement of Death . When a patient dies in a licensed hospice or a nursing home in the absence of a physician and under specific circumstances, that person may be pronounced dead as provided by law in GA Code Ann, 31-7-16 and . New York: Jeremy P. Tarcher/Penguin. 0000000787 00000 n Policies and procedures of institutions Any institution, as defined in subsection (a) of section 19a-490 of the Connecticut General Statutes, which employs a registered nurse functioning pursuant to these regulations shall . 3.1.18 Registered Nurse Pronouncement of Death (a) Policy California Correctional Health Care Services (CCHCS) shall permit Registered Nurses (RNs ) to make the determination and pronouncement of patient death under specified circumstances. endobj Epidemiology of Dying & End-of-Life Experience Co. Wrede-Seaman, L. (1999).Symptom management algorithms: A handbook for palliative care. The requirements as outlined in WAC 246-839-830 would apply: Determination and Pronouncement of Death . National FAeHx2!x)6N)wx$y MXx W$6S!`H{c&Xx Wyfl}) F:(XwwS? <> endobj Our members represent more than 60 professional nursing specialties. search parameters, plus information about the data such as format, WAC 246-840-830 identifies the requirements for the RN to determine and pronounce death. { : Continuum. (2002).Scope and standards of hospice and palliative nursing practice. Callanan, M., & Kelley, P. (1997).Final gifts: Understanding the special awareness, needs, and communications of the dying. Ostaseski, F., & Zen Hospice Project. Some page levels are currently hidden. Each search returns a list of websites that display data matching the Honoring Choices informs and empowers adults, 18 years old and older, to make a health care plan to receive the best possible care that honors their choices, all through their lives. 17 0 obj << /Linearized 1 /O 19 /H [ 880 279 ] /L 120281 /E 107017 /N 3 /T 119823 >> endobj xref 17 22 0000000016 00000 n [ 13 0 R] Massachusetts Commission on End of Life Care Consumer Web site that explains the specialty of hospice and palliative medicine and its benefits to patients and families. Garden City, N.Y: Doubleday. RCW 18.79 and WAC 245-840 do not address settings. Offers Please limit your input to 500 characters. Hoblitzelle, O. 4. 5 0 obj Bolen, J. S. (1996).Close to the bone: Life-threatening illness and the search for meaning. A professional membership organization providing a web site on health care proxy, advance directives, discussion guides, and links to other resources. non-profit organization devoted exclusively to hospice. Online Resources and Recommended Readings. 230 0 obj <> endobj Page 1 of 2. Use this button to show and access all levels. Minneapolis: Augsburg. Resident pronounced at 10.30AM. MD notified, new orders - RN Pronouncement and order to release body to funeral home confirmed by Jane Doe NP covering for Dr John Doe. pt found w/o pulse, respirations. Telephone: 850-681-2010, Guide to Help Palliative CarePrograms Successfully Complete State Operations Manual Appendix M - Guidance to Surveyors: Hospice (Rev. Simply placing pronouncement of death by RN or something similar in the search bar of your search engine can identify other states. (c) "Anticipated Death" is death which is, in the opinion of the attending physician, expected due to illness, infirmity or disease. A. Honoring Choices md notified. endobj Levine, S. (1987).Healing into life and death. Choosing a specialty can be a daunting task and we made it easier. Before making a pronouncement of death, a nurse practitioner shall make a reasonable effort to contact the attending physician or medical examiner. <> Please complete the information pertaining to the decedent as well as the cause of death information as this document will be used to . stream <> Sheehan, D. C., & Forman, W. B. Death within 24 hours of admission to a hospital or nursing home 6. If there are also court forms on a topic, we link to that section of official court forms for your convenience. WAC . We had one heavy set resident who was a beast in regards to pulses. Hospice and Palliative Nurses Association., & American Nurses Association. spoke with dtr on phone. Select the Get form key to open the document and begin editing. By Ida Koivisto, BSN, RN, PHN. %%EOF 2 0 obj Always check your own facility's policy for RN pronouncements.and don't forget, sometimes the nurse CAN'T pronouncean unexpected death, a death within 24 hours of admission (unless the person came in to die)the circular letter from this state is about 3 pages long on when to call the ME. 1 %Q!5zp$sLgNXB8lM>ODpu~ *\q*YOxrG,dJU}!p`0IzzCFq > G endstream endobj 39 0 obj <>/Metadata 5 0 R/PieceInfo<>>>/Pages 4 0 R/PageLayout/OneColumn/OCProperties<>/OCGs[40 0 R]>>/StructTreeRoot 7 0 R/Type/Catalog/Lang( E N - U S)/LastModified(D:20070918092624)/PageLabels 2 0 R>> endobj 40 0 obj <. New York: Springer Pub. endobj 'I7[wzw$ If you cannot find a form you need, you can contact the Trial Court Law Libraries and they will assist you. allnurses, LLC, 175 Pearl St Ste 355, Brooklyn NY 11201 Arlington, VA 22209 Order to release body to funeral home received. 10 0 obj A coalition of individuals and organization who seek to improve end-of-life care in Massachusetts. QksaG+ofZ69O=rIH(T8Gq^Q[/NR7/{# iKq0XU*yUFkoqC0S-r=J%Z7AnfUYdkY-{EZH6DhW`z m^@G[+!xPCm}@ ALGY yT+}8/$`4T(Wt!b@%n@6@rG>m2w04;~5{ 48j]f)[3IBC:A5nDe`'X2 /(v[QY:J1 f0vdBdUmCZ\qz}7D51H e cFUVco6J5oRWG@iiJIf53(lNKCf H;$M?j Tg8 endstream endobj 59 0 obj <>/Size 38/Type/XRef>>stream PalliativeDoctors.orgConsumer Web site that explains the specialty of hospice and palliative medicine and its benefits to patients and families. PerinatalHospice.org is a clearinghouse of information about perinatal hospice and palliative care. Institutional policy may also guide the nurse's role in the assessment of death. 0000002851 00000 n or in the office. The Registered Nurse will notify the physician after the pronouncement of death. (2000).Being a compassionate companion: A series. 0000060779 00000 n Mesothelioma Cancer Network St. Pierre, P. J. Thorofare, N.J: Slack. Order received for RN pronouncement. Users can search by topic, state, or a set of pre-written questions. The obligation also must conform to the RN's or APRN's legal and ethical mandates. dQ0xf$OM f+?! San Francisco, CA: Institute on Dying (Zen Hospice Project). >x.4Q9c=@6{&q0 (1992). Since 1997, allnurses is trusted by nurses around the globe. Byock, I. pt was dnr. MD notified, new orders - RN Pronouncement and order to release body to funeral home confirmed by Jane Doe NP covering for Dr John Doe. %PDF-1.6 % v fG#i}aH#ia8ZK]EV?X0T1dQSIf_x,v$XuhI(I(PRPr .4Yel^|NXCqo8Ur8^*s( =% Heb=@ E- endstream endobj 38 0 obj 166 endobj 19 0 obj << /Type /Page /Parent 14 0 R /Resources 20 0 R /Contents 28 0 R /MediaBox [ 0 0 612 792 ] /CropBox [ 0 0 612 792 ] /Rotate 0 >> endobj 20 0 obj << /ProcSet [ /PDF /Text ] /Font << /TT2 25 0 R /TT4 21 0 R /TT6 22 0 R /TT8 29 0 R >> /ExtGState << /GS1 33 0 R >> /ColorSpace << /Cs6 27 0 R >> >> endobj 21 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 121 /Widths [ 250 0 0 0 0 0 0 0 0 0 0 0 250 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 667 667 667 722 0 667 0 0 389 0 0 0 889 0 0 611 0 0 0 611 0 0 0 0 0 0 0 0 0 0 0 0 500 500 444 500 444 333 500 556 278 0 500 278 778 556 500 500 0 389 389 278 556 444 667 0 444 ] /Encoding /WinAnsiEncoding /BaseFont /MALBDH+TimesNewRoman,BoldItalic /FontDescriptor 23 0 R >> endobj 22 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 121 /Widths [ 250 0 0 0 0 0 0 0 0 0 0 0 250 0 250 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 722 667 722 722 667 611 0 0 389 0 0 0 0 722 0 611 0 722 556 667 0 722 0 0 0 0 0 0 0 0 500 0 500 556 444 556 444 333 500 556 278 0 556 278 833 556 500 556 556 444 389 333 556 500 722 500 500 ] /Encoding /WinAnsiEncoding /BaseFont /MALBKI+TimesNewRoman,Bold /FontDescriptor 26 0 R >> endobj 23 0 obj << /Type /FontDescriptor /Ascent 891 /CapHeight 656 /Descent -216 /Flags 98 /FontBBox [ -547 -307 1206 1032 ] /FontName /MALBDH+TimesNewRoman,BoldItalic /ItalicAngle -15 /StemV 142.397 /FontFile2 31 0 R >> endobj 24 0 obj << /Type /FontDescriptor /Ascent 891 /CapHeight 656 /Descent -216 /Flags 34 /FontBBox [ -568 -307 2000 1007 ] /FontName /MALBAN+TimesNewRoman /ItalicAngle 0 /StemV 94 /XHeight 0 /FontFile2 32 0 R >> endobj 25 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 146 /Widths [ 250 0 0 0 0 0 0 0 333 333 0 0 250 333 250 278 500 500 500 500 500 500 500 500 500 500 278 278 0 0 0 0 0 722 0 667 722 611 556 722 722 333 0 0 611 889 722 722 556 0 667 556 611 0 722 0 0 0 0 0 0 0 0 500 0 444 500 444 500 444 333 500 500 278 278 500 278 778 500 500 500 500 333 389 278 500 500 722 500 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 ] /Encoding /WinAnsiEncoding /BaseFont /MALBAN+TimesNewRoman /FontDescriptor 24 0 R >> endobj 26 0 obj << /Type /FontDescriptor /Ascent 891 /CapHeight 656 /Descent -216 /Flags 34 /FontBBox [ -558 -307 2000 1026 ] /FontName /MALBKI+TimesNewRoman,Bold /ItalicAngle 0 /StemV 160 /XHeight 0 /FontFile2 36 0 R >> endobj 27 0 obj [ /ICCBased 34 0 R ] endobj 28 0 obj << /Length 1982 /Filter /FlateDecode >> stream