Assisted Deliveries Certification
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Office of the City Health Officer City of San Fernando, La Union
CERTIFICATION This is to certify that MR. JEFFERSON GOMEZ AGUILA of Union Christian College had two assisted deliveries during his days of duty in this institution.
DELIVERIES ASSISTED No .
Case No.
Diagnosis
1
Home Delive ry
Pregnancy Uterine 39 weeks Age of Gestation Cephalic in Labor Gravida 2 Para 1 (G2P1)
2
Home Delive ry
Pregnancy Uterine 40 weeks Age of Gestation Cephalic in Labor Gravida 2 Para 1 (G2P1)
Name of Mother
Ag e
Date of Delivery
Time of Delive ry
Gende r of Baby
Name of Hospital
Type of Delivery
Raquel Dumaguin Palisoc
27
February 24, 2007
8:30 AM
Female
Santiago Sur Health Center
Normal Spontaneo us Delivery
City of San Fernando, La Union
Glory Amin Valdez
28
January 28, 2007
8:35 AM
Female
Tanqui Health Center City of San Fernando, La Union
Normal Spontaneo us Delivery
Supervised by: Name & Signature of Qualified Clinical Instructor
Charmaine S. Abenes PRC #: 0266421 PNA #:16309 MAN units: 42 units
Charmaine S. Abenes PRC #: 0266421 PNA #:16309 MAN units: 42 units
This certification is issued to MR. JEFFERSON GOMEZ AGUILA this 19th of March 2007 for all good intents and purposes it may serve.
_____________________________________________
_________________________________
ELVIRA P. ORDINARIO, RM
EMILY LAROYA, RN
Date Signed: _________ Midwife II License No. 0062347 Valid Until: August 18, 2008
Date Signed: _________ Nurse III a. License No. 0164680 Valid Until: December 22, 2008 b. PNA No.: 16293 Valid Until: December 2007 c. ANSAP No.: 09241 Valid Until: December 2007
____________________________________
EDUARDO S. POSADAS, MD Date Signed: _________
City Health Officer II
CERTIFICATION This is to certify that MR. JEFFERSON GOMEZ AGUILA of Union Christian College had two assisted deliveries during his days of duty in this institution.
DELIVERIES ASSISTED No .
Case No.
Diagnosis
1
Home Delive ry
Pregnancy Uterine 39 weeks Age of Gestation Cephalic in Labor Gravida 2 Para 1 (G2P1)
2
Home Delive ry
Pregnancy Uterine 40 weeks Age of Gestation Cephalic in Labor Gravida 2 Para 1 (G2P1)
Name of Mother
Ag e
Date of Delivery
Time of Delive ry
Gende r of Baby
Name of Hospital
Type of Delivery
Raquel Dumaguin Palisoc
27
February 24, 2007
8:30 AM
Female
Santiago Sur Health Center
Normal Spontaneo us Delivery
City of San Fernando, La Union
Glory Amin Valdez
28
January 28, 2007
8:35 AM
Female
Tanqui Health Center City of San Fernando, La Union
Normal Spontaneo us Delivery
Supervised by: Name & Signature of Qualified Clinical Instructor
Charmaine S. Abenes PRC #: 0266421 PNA #:16309 MAN units: 42 units
Charmaine S. Abenes PRC #: 0266421 PNA #:16309 MAN units: 42 units
This certification is issued to MR. JEFFERSON GOMEZ AGUILA this 19th of March 2007 for all good intents and purposes it may serve.
_____________________________________________
_________________________________
ELVIRA P. ORDINARIO, RM
EMILY LAROYA, RN
Date Signed: _________ Midwife II License No. 0062347 Valid Until: August 18, 2008
Date Signed: _________ Nurse III a. License No. 0164680 Valid Until: December 22, 2008 b. PNA No.: 16293 Valid Until: December 2007 c. ANSAP No.: 09241 Valid Until: December 2007
____________________________________
EDUARDO S. POSADAS, MD Date Signed: _________
City Health Officer II
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