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Illness or injury. My physician and one other physician will have examined me and believe that I cannot recover and that death is likely to occur within a relatively short time if I do not receive life-sustaining treatment. Instructions and other information to assist in completing this document are set forth within brackets and in italic type. OHIO HEALTH CARE POWER OF ATTORNEY PAGE TWO OF TWELVE Naming of My Agent. The person named below is my agent who will make health care decisions fo.

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