Florence
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Republic of the Philippines NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY College of Nursing Cabanatuan City NAME OF STUDENT: SALDIVAR, FLORENCE CEREZO Name and Address of School: Nueva Ecija University of Science and Technology, Gen. Tinio St. Cabanatuan City, 3100 Accreditation Level (if any): Not Applicable Date School / Program was Recognized: December 2, 2003 No.: Board Resolution No. 96-A Year: Series of 2003 First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the Bachelor of Science in Nursing Program: 2005 Year Graduated (BSN Program): 2009
PREPARED BY:
SUPERVISED BY:
SUPERVISED BY:
NOTED BY:
CONCURRED BY:
NOTED BY:
FLORENCE C. SALDIVAR NAME OF STUDENT Date Signed:
MR. EMILSON F. REGUYAL Degree: Bachelor of Science in Nursing Registered Nurse 27 Units Master of Arts in Nursing PRC No: 0452116 Valid Until: July 31, 2010 PNA No: 039328 Valid Until: December 31, 2010 Date Signed:
MR. JAMES BRIAN A.GICALE Degree: Bachelor of Science in Nursing Registered Nurse 27 Units Master of Arts in Nursing PRC No: 0404083 Valid Until: January 13,2012 PNA No: 009597 Valid Until: December 2009 Date Signed:
MS. LUZVIMINDA I. DALLO RLE COORDINATOR Degree: Bachelor of Science in Nursing Registered Nurse Master of Arts in Nursing PRC No: 0086572 Valid Until: August 19, 2010 PNA No: 19755 Valid Until: Lifetime Member
MS. BIENVENIDA R. CAPULE CHIEF NURSE Dr. Paulino J. Garcia Memorial Research and Medical Center Degree: Bachelor of Science in Nursing Registered Nurse Master of Arts in Nursing PRC No: 0028001 Valid Until: March 22, 2011 PNA No: 7629 Valid Until: Lifetime Member Date Signed:
MS. EPPIE DC. BUGARIN DEAN, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Registered Nurse Registered Midwife Master of Arts in Nursing PRC No: 0085974 Valid Until: April 3, 2011 PNA No: 17977 Valid Until: Lifetime Member
Date Signed:
ADPCN No: 0662 Valid Until: December 2009 Date Signed: II. MINOR OPERATIONS N o.
Date Perform
Case No.
Name of Patient
Diagnosis
1.
September 9,2008
8707 08
Lely Villafuerte
Pleural Effusion, Right
2.
September 10,2008
8708 81
Gerald Tiangco
3.
September 10,2008
8708 71
4.
September 23, 2008
5.
September 24, 2008
Operation Performed
Type of Anesthesia
Name of Surgeon
Chest Thoracostomy Tube, Right
Local Anesthesia
Dr. Ariel Tugade
Ruptured External Auditory canal, Left ear
Suturing
Local Anesthesia
Dr. Dulce Grace Esposo
Jomar Galleges
Open Reduction Middle Maleolus Right secondary to fall
Suturing
8727 21
Edgar Aquino
Indirect Inguinal Hernia Incarcerated, Left
Mesh Herniorrhaphy
Spinal Anesthesia
8728 40
Elaine Gonzales
Suppurative Appendicitis
Emergency Appendectomy
Spinal Anesthesia
Local Anesthesia
Dr. Genesis Cruz Dr. Hendrick Klein Acosta Dr. Dulce Grace Esposo Dr. Manuel Paguio Jr. Dr. Dennis Del Rosario
Republic of the Philippines NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY College of Nursing Cabanatuan City NAME OF STUDENT: SALDIVAR, FLORENCE CEREZO Name and Address of School: Nueva Ecija University of Science and Technology, Gen. Tinio St. Cabanatuan City, 3100 Accreditation Level (if any): Not Applicable Date School / Program was Recognized: December 2, 2003 No.: Board Resolution No. 96-A Year: Series of 2003 First Course (if any): Not Applicable School Graduated: Not Applicable
Name of Hospital Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center
Year of Admission in the Bachelor of Science in Nursing Program: 2005 Year Graduated (BSN Program): 2009 V.CORD DRESSING No .
Case No.
Date Performed
Name of Baby
Gender of Baby
Name of Mother
Age
Name of Hospital
1.
867532
August 25,2008
Baby Africano
Girl
Angeli Raymundo
22 y/o
2.
867627
August 26,2008
Baby Elas
Boy
Elsie Elas
26 y/o
3.
867630
August 26,2008
Baby Pronto
Boy
Leinalyn Carrasco
28 y/o
4
867592
August 26,2008
Baby agdatu
Girl
Amelita Gerosa
25 y/o
5.
505438
August 26,2008
Baby De Vera
Girl
Maribel Cruza
24 y/o
Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center
PREPARED BY:
SUPERVISED BY:
NOTED BY:
CONCURRED BY:
NOTED BY:
FLORENE C. SALDIVAR NAME OF STUDENT Date Signed:
MS. FRANCES GRACE D. ANGELES Degree: Bachelor of Science in Nursing Registered Nurse 27 Units Master of Arts in Nursing PRC No: 0435021 Valid Until: December 4, 2010 PNA No: 039327 Valid Until: December 31, 2009 Date Signed:
MS. LUZVIMINDA I. DALLO RLE COORDINATOR Degree: Bachelor of Science in Nursing Registered Nurse Master of Arts in Nursing PRC No: 0086572 Valid Until: August 19, 2010 PNA No: 19755 Valid Until: Lifetime Member Date Signed:
MS. BIENVENIDA R. CAPULE CHIEF NURSE Dr. Paulino J. Garcia Memorial Research and Medical Center Degree: Bachelor of Science in Nursing Registered Nurse Master of Arts in Nursing PRC No: 0028001 Valid Until: March 22, 2011 PNA No: 7629 Valid Until: Lifetime Member Date Signed:
MS. EPPIE DC. BUGARIN DEAN, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Registered Nurse Registered Midwife Master of Arts in Nursing PRC No: 0085974 Valid Until: April 3, 2011 PNA No: 17977 Valid Until: Lifetime Member ADPCN No: 0662 Valid Until: December 2009 Date Signed:
Republic of the Philippines NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY College of Nursing Cabanatuan City
NAME OF STUDENT: SALDIVAR, FLORENCE CEREZO Name and Address of School: Nueva Ecija University of Science and Technology, Gen. Tinio St. Cabanatuan City, 3100 Accreditation Level (if any): Not Applicable Date School / Program was Recognized: December 2, 2003 No.: Board Resolution No. 96-A Year: Series of 2003 III. ACTUAL DEILIVERIES No .
Case No.
Diagnosis
Name of Patient
Age
Date of Delivery
PREPARED BY: SUPERVISED BY: NOTED BY: Gravida 1 Parity 0 Pregnancy Uterine 38 1 877908 Lanie Enriquez 19 y/o October 20, 2008 3/7 weeks Age of Gestation Cephalic in MS. LAENELLE V. ABERGAS MS. LUZVIMINDA I. DALLO FLORENE C. SALDIVAR Labor Degree: Bachelor of Science in RLE COORDINATOR NAME OF STUDENT Nursing Degree: Bachelor of Science in Nursing Date Signed: Gravida 3 Parity 2 Registered Nurse Registered Nurse 2 877978 Pregnancy Uterine Full Term9Cephalic in Jenifer 25 y/o October 20, 2008 Units Master of Arts in Espiritu Master of Arts in Nursing Labor Nursing PRC No: 0086572 PRC No: 0423121 Valid Until: August 19, 2010 Gravida 7 ParityValid 6 Pregnancy Uterine15,2010 38 Until: October PNA No: 19755 3 879218 6/7weeks Age of Gestation Cephalic in Estela dele Cruz y/o October PNA No: 039329 Valid Until: 39 Lifetime Member22, 2008 Labor Valid Until: December 31,2009 Date Signed: Date Signed: Gravida 2 Parity 1 Pregnancy Uterine38 2/7 4 879 Elsie CapIillo 23 y/o October 28, 2008 weeks Age of Gestation Cephalic in Labor
Time of Delivery
Gender of the Baby
Name of Hospital
Type of Delivery
CONCURRED BY: NOTED BY: Dr. Paulino J. Garcia Memorial 4: 34 pm Girl Normal Spontaneous Delivery Research and Medical Center MS. BIENVENIDA R. CAPULE MS. EPPIE DC. BUGARIN CHIEF NURSE DEAN, COLLEGE OF NURSING Dr. Paulino J. Garcia Memorial Research and Degree: Bachelor of Science in Nursing Medical Center Dr. Paulino J. Garcia MemorialRegistered Nurse 8:13pm BachelorBoy Normal Spontaneous Delivery Degree: of Science Research in Nursingand Medical CenterRegistered Midwife Registered Nurse Master of Arts in Nursing Master of Arts in Nursing PRC No: 0085974 PRC No: 0028001 Valid Until: April 3, 2011 Dr. Paulino J. Garcia Memorial 7: 57 Until: pm MarchGirl Normal Spontaneous Delivery Valid 22, 2011 Research and Medical PNA No: 17977 Center PNA No: 7629 Valid Until: Lifetime Member Valid Until: Lifetime Member ADPCN No: 0662 Dr. Paulino J. Garcia Memorial Date Signed: Valid Until: December 2009 10:15 pm Boy Normal Spontaneous Delivery Research and Medical Center Date Signed:
First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the Bachelor of Science in Nursing Program: 2005 Year Graduated (BSN Program): 2009
Republic of the Philippines NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY College of Nursing Cabanatuan City NAME OF STUDENT: SALDIVAR, FLORENCE CEREZO Name and Address of School: Nueva Ecija University of Science and Technology, Gen. Tinio St. Cabanatuan City, 3100 Accreditation Level (if any): Not Applicable Date School / Program was Recognized: December 2, 2003 No.: Board Resolution No. 96-A Year: Series of 2003 First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the Bachelor of Science in Nursing Program: 2005 Year Graduated (BSN Program): 2009
III. ASSISTED DELIVERIS No .
Case No.
Diagnosis
Name of Patient
Age
Date of Delivery
Time of Delivery
Gender of the Baby
Name of Hospital
Type of Delivery
1
877908
Gravida 1 Parity 0 Pregnancy Uterine 38 weeks Age of Gestation Cephalic in Labor
Rosalyn Romasanta
30 y/o
October 20, 2008
5: 53 pm
Girl
Dr. Paulino J. Garcia Memorial Research and Medical Center
Normal Spontaneous Delivery
2
880287
Gravida 2 Parity 1 Pregnancy Uterine 32 weeks Preterm in Labor
Rosalie dela Cruz
23 y/o
October 28, 2008
11:05 pm
Girl
Dr. Paulino J. Garcia Memorial Research and Medical Center
Normal Spontaneous Delivery
3
879212
Gravida 1 Parity 0 Pregnancy Uterine Full Term Cephalic in Labor
Joan Mercado
25 y/o
October 22, 2008
3: 00 pm
Girl
Dr. Paulino J. Garcia Memorial Research and Medical Center
Normal Spontaneous Delivery
4
879274
Gravida 2 Parity 1 Pregnancy Uterine Full Term Cephalic in Labor
Lulu Gutierrez
32 y/o
October 22, 2008
9: 25 pm
Boy
Dr. Paulino J. Garcia Memorial Research and Medical Center
Normal Spontaneous Delivery
PREPARED BY:
SUPERVISED BY:
NOTED BY:
CONCURRED BY:
NOTED BY:
FLORENE C. SALDIVAR NAME OF STUDENT Date Signed:
MS. LAENELLE V. ABERGAS Degree: Bachelor of Science in Nursing Registered Nurse 9 Units Master of Arts in Nursing PRC No: 0423121 Valid Until: October 15,2010 PNA No: 039329 Valid Until: December 31,2009 Date Signed:
MS. LUZVIMINDA I. DALLO RLE COORDINATOR Degree: Bachelor of Science in Nursing Registered Nurse Master of Arts in Nursing PRC No: 0086572 Valid Until: August 19, 2010 PNA No: 19755 Valid Until: Lifetime Member Date Signed:
MS. BIENVENIDA R. CAPULE CHIEF NURSE Dr. Paulino J. Garcia Memorial Research and Medical Center Degree: Bachelor of Science in Nursing Registered Nurse Master of Arts in Nursing PRC No: 0028001 Valid Until: March 22, 2011 PNA No: 7629 Valid Until: Lifetime Member Date Signed:
MS. EPPIE DC. BUGARIN DEAN, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Registered Nurse Registered Midwife Master of Arts in Nursing PRC No: 0085974 Valid Until: April 3, 2011 PNA No: 17977 Valid Until: Lifetime Member ADPCN No: 0662 Valid Until: December 2009 Date Signed:
Republic of the Philippines NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY College of Nursing Cabanatuan City NAME OF STUDENT: SALDIVAR, FLORENCE CEREZO Name and Address of School: Nueva Ecija University of Science and Technology, Gen. Tinio St. Cabanatuan City, 3100 Accreditation Level (if any): Not Applicable Date School / Program was Recognized: December 2, 2003 No.: Board Resolution No. 96-A Year: Series of 2003 First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the Bachelor of Science in Nursing Program: 2005 Year Graduated (BSN Program): 2009
IV. Actual Delivery No .
Case No.
Diagnosis
Name of Patient
Age
Date of Delivery
Time of Delivery
Gender of the Baby
Name of Hospital
Type of Delivery
1
217603
Gravida 1 Parity 2 Pregnancy Uterine Full Term Cephalic in Labor
Marivic Tolentino Agua
18
December 18, 2008
5:25 pm
Boy
Gapan District Hospital
Normal Spontaneous Delivery
PREPARED BY:
SUPERVISED BY:
CONCURRED BY:
NOTED BY:
NOTED BY:
MS. LUZVIMINDA I. DALLO RLE COORDINATOR, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Master of Arts in Nursing PRC No: 0086572 Valid Until: August 19, 2010 PNA No: 19755 Valid Until: Lifetime Member Date Signed:
FLORENE C. SALDIVAR NAME OF STUDENT Date Signed:
MS. EPPIE DC. BUGARIN DEAN, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Registered Midwife Master of Arts in Nursing PRC No: 0085974 Valid Until: April 3, 2011 PNA No: 17977 Valid Until: Lifetime Member ADPCN No: 0662 Valid Until: December 2009 Date Signed:
Republic of the Philippines NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY College of Nursing Cabanatuan City NAME OF STUDENT: SALDIVAR, FLORENCE CEREZO Name and Address of School: Nueva Ecija University of Science and Technology, Gen. Tinio St. Cabanatuan City, 3100 Accreditation Level (if any): Not Applicable Date School / Program was Recognized: December 2, 2003 No.: Board Resolution No. 96-A Year: Series of 2003 First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the Bachelor of Science in Nursing Program: 2005 Year Graduated (BSN Program): 2009 IV. Delivery Assisted No .
Case No.
Diagnosis
Name of Patient
Age
Date of Delivery
Time of Delivery
Gender of the Baby
Name of Hospital
Type of Delivery
1
220811
Gravida 6 Parity 5 Pregnancy Uterine Full Term Cephalic in Labor
Teresita Reyes Mustapha
41
January 22, 2009
9:36 am
Girl
Gapan District Hospital
Normal Spontaneous Delivery
PREPARED BY: FLORENE C. SALDIVAR NAME OF STUDENT Date Signed:
SUPERVISED BY:
NOTED BY:
CONCURRED BY:
MS. LUZVIMINDA I. DALLO RLE COORDINATOR, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Master of Arts in Nursing PRC No: 0086572 Valid Until: August 19, 2010 PNA No: 19755 Valid Until: Lifetime Member Date Signed:
Republic of the Philippines NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY College of Nursing Cabanatuan City
NAME OF STUDENT: SALDIVAR, FLORENCE CEREZO Name and Address of School: Nueva Ecija University of Science and Technology, Gen. Tinio St. Cabanatuan City, 3100 Accreditation Level (if any): Not Applicable Date School / Program was Recognized: December 2, 2003 No.: Board Resolution No. 96-A Year: Series of 2003 First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the Bachelor of Science in Nursing Program: 2005 Year Graduated (BSN Program): 2009
NOTED BY: MS. EPPIE DC. BUGARIN DEAN, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Registered Midwife Master of Arts in Nursing PRC No: 0085974 Valid Until: April 3, 2011 PNA No: 17977 Valid Until: Lifetime Member ADPCN No: 0662 Valid Until: December 2009 Date Signed:
PREPARED BY:
SUPERVISED BY:
NOTED BY:
CONCURRED BY:
APPROVED BY:
FLORENCE C. SALDIVAR NAME OF STUDENT Date Signed:
JENNIFER G. SAN PEDRO, RN, CLINICAL INSTRUCTOR Degree: Bachelor of Science in Nursing 18 Units Master of Arts in Nursing PRC No: 0525719 Valid Until: August 26, 2010 PNA No: 01375 Valid Until: December 31, 2009 Date Signed:
LUZVIMINDA I. DALLO, RN, MAN RLE COORDINATOR, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Master of Arts in Nursing PRC No: 0086572 Valid Until: August 19, 2010 PNA No: 19755 Valid Until: Lifetime Member Date Signed:
ALEXANDER P. MALUBAG, RN, MAN CHIEF NURSE, ELJ Degree: Bachelor of Science in Nursing Master of Arts in Nursing PRC No: 00119925 Valid Until: December 1, 2011 PNA No: 11108 Valid Until: Life Time Member Date Signed:
EPPIE DC. BUGARIN RM, RN, MAN DEAN, COLLEGE OF NURSING Degree: BSN, RM, RN, MAN PRC No: 0085974 Valid Until: April 3, 2011 PNA No: 17977 Valid Until: Lifetime Member ADCPN No: 0662 Valid Until: December 2009 Date Signed:
I. MAJOR SCRUBS No .
Date Perform
Case No.
Name of Patient
Diagnosis
1.
July 6, 2008
2991
Analyn Serrano Salazar
Pregnancy Uterine 39 weeks Age of Gestation
2.
December 5, 2008
5653
Daisy Calanday Alvaran
Gravida 1 Parity 0 Pregnancy Uterine 38 weeks Aga of Gestation Cephalic Borderline
Operation Performed
Type of Anesthesia
Name of Surgeon
Name of Hospital
Lower Cervical Caesarean Section/ Baby Girl
Spinal Anesthesia
Dr. Reyes
Euardo L. Joson Memorial Hospital
Lower Cervical Caesarean Section I
Spinal Anesthesia
Dr. Hudencial
Euardo L. Joson Memorial Hospital
PREPARED BY:
SUPERVISED BY:
SUPERVISED BY:
NOTED BY:
CONCURRED BY:
NOTED BY:
FLORENCE C. SALDIVAR NAME OF STUDENT Date Signed:
MR. EMILSON F. REGUYAL Degree: Bachelor of Science in Nursing Registered Nurse 27 Units Master of Arts in Nursing PRC No: 0452116 Valid Until: July 31, 2010 PNA No: 039328 Valid Until: December 31, 2010 Date Signed:
MR. JAMES BRIAN A.GICALE Degree: Bachelor of Science in Nursing Registered Nurse 27 Units Master of Arts in Nursing PRC No: 0404083 Valid Until: January 13,2012 PNA No: 009597 Valid Until: December 2009 Date Signed:
MS. LUZVIMINDA I. DALLO RLE COORDINATOR Degree: Bachelor of Science in Nursing Registered Nurse Master of Arts in Nursing PRC No: 0086572 Valid Until: August 19, 2010 PNA No: 19755 Valid Until: Lifetime Member
MS. BIENVENIDA R. CAPULE CHIEF NURSE Dr. Paulino J. Garcia Memorial Research and Medical Center Degree: Bachelor of Science in Nursing Registered Nurse Master of Arts in Nursing PRC No: 0028001 Valid Until: March 22, 2011 PNA No: 7629 Valid Until: Lifetime Member Date Signed:
MS. EPPIE DC. BUGARIN DEAN, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Registered Nurse Registered Midwife Master of Arts in Nursing PRC No: 0085974 Valid Until: April 3, 2011 PNA No: 17977 Valid Until: Lifetime Member
Date Signed:
ADPCN No: 0662 Valid Until: December 2009 Date Signed: II. MINOR OPERATIONS N o.
Date Perform
Case No.
Name of Patient
Diagnosis
1.
September 9,2008
8707 08
Lely Villafuerte
Pleural Effusion, Right
2.
September 10,2008
8708 81
Gerald Tiangco
3.
September 10,2008
8708 71
4.
September 23, 2008
5.
September 24, 2008
Operation Performed
Type of Anesthesia
Name of Surgeon
Chest Thoracostomy Tube, Right
Local Anesthesia
Dr. Ariel Tugade
Ruptured External Auditory canal, Left ear
Suturing
Local Anesthesia
Dr. Dulce Grace Esposo
Jomar Galleges
Open Reduction Middle Maleolus Right secondary to fall
Suturing
8727 21
Edgar Aquino
Indirect Inguinal Hernia Incarcerated, Left
Mesh Herniorrhaphy
Spinal Anesthesia
8728 40
Elaine Gonzales
Suppurative Appendicitis
Emergency Appendectomy
Spinal Anesthesia
Local Anesthesia
Dr. Genesis Cruz Dr. Hendrick Klein Acosta Dr. Dulce Grace Esposo Dr. Manuel Paguio Jr. Dr. Dennis Del Rosario
Republic of the Philippines NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY College of Nursing Cabanatuan City NAME OF STUDENT: SALDIVAR, FLORENCE CEREZO Name and Address of School: Nueva Ecija University of Science and Technology, Gen. Tinio St. Cabanatuan City, 3100 Accreditation Level (if any): Not Applicable Date School / Program was Recognized: December 2, 2003 No.: Board Resolution No. 96-A Year: Series of 2003 First Course (if any): Not Applicable School Graduated: Not Applicable
Name of Hospital Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center
Year of Admission in the Bachelor of Science in Nursing Program: 2005 Year Graduated (BSN Program): 2009 V.CORD DRESSING No .
Case No.
Date Performed
Name of Baby
Gender of Baby
Name of Mother
Age
Name of Hospital
1.
867532
August 25,2008
Baby Africano
Girl
Angeli Raymundo
22 y/o
2.
867627
August 26,2008
Baby Elas
Boy
Elsie Elas
26 y/o
3.
867630
August 26,2008
Baby Pronto
Boy
Leinalyn Carrasco
28 y/o
4
867592
August 26,2008
Baby agdatu
Girl
Amelita Gerosa
25 y/o
5.
505438
August 26,2008
Baby De Vera
Girl
Maribel Cruza
24 y/o
Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center Dr. Paulino J. Garcia Memorial Research and Medical Center
PREPARED BY:
SUPERVISED BY:
NOTED BY:
CONCURRED BY:
NOTED BY:
FLORENE C. SALDIVAR NAME OF STUDENT Date Signed:
MS. FRANCES GRACE D. ANGELES Degree: Bachelor of Science in Nursing Registered Nurse 27 Units Master of Arts in Nursing PRC No: 0435021 Valid Until: December 4, 2010 PNA No: 039327 Valid Until: December 31, 2009 Date Signed:
MS. LUZVIMINDA I. DALLO RLE COORDINATOR Degree: Bachelor of Science in Nursing Registered Nurse Master of Arts in Nursing PRC No: 0086572 Valid Until: August 19, 2010 PNA No: 19755 Valid Until: Lifetime Member Date Signed:
MS. BIENVENIDA R. CAPULE CHIEF NURSE Dr. Paulino J. Garcia Memorial Research and Medical Center Degree: Bachelor of Science in Nursing Registered Nurse Master of Arts in Nursing PRC No: 0028001 Valid Until: March 22, 2011 PNA No: 7629 Valid Until: Lifetime Member Date Signed:
MS. EPPIE DC. BUGARIN DEAN, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Registered Nurse Registered Midwife Master of Arts in Nursing PRC No: 0085974 Valid Until: April 3, 2011 PNA No: 17977 Valid Until: Lifetime Member ADPCN No: 0662 Valid Until: December 2009 Date Signed:
Republic of the Philippines NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY College of Nursing Cabanatuan City
NAME OF STUDENT: SALDIVAR, FLORENCE CEREZO Name and Address of School: Nueva Ecija University of Science and Technology, Gen. Tinio St. Cabanatuan City, 3100 Accreditation Level (if any): Not Applicable Date School / Program was Recognized: December 2, 2003 No.: Board Resolution No. 96-A Year: Series of 2003 III. ACTUAL DEILIVERIES No .
Case No.
Diagnosis
Name of Patient
Age
Date of Delivery
PREPARED BY: SUPERVISED BY: NOTED BY: Gravida 1 Parity 0 Pregnancy Uterine 38 1 877908 Lanie Enriquez 19 y/o October 20, 2008 3/7 weeks Age of Gestation Cephalic in MS. LAENELLE V. ABERGAS MS. LUZVIMINDA I. DALLO FLORENE C. SALDIVAR Labor Degree: Bachelor of Science in RLE COORDINATOR NAME OF STUDENT Nursing Degree: Bachelor of Science in Nursing Date Signed: Gravida 3 Parity 2 Registered Nurse Registered Nurse 2 877978 Pregnancy Uterine Full Term9Cephalic in Jenifer 25 y/o October 20, 2008 Units Master of Arts in Espiritu Master of Arts in Nursing Labor Nursing PRC No: 0086572 PRC No: 0423121 Valid Until: August 19, 2010 Gravida 7 ParityValid 6 Pregnancy Uterine15,2010 38 Until: October PNA No: 19755 3 879218 6/7weeks Age of Gestation Cephalic in Estela dele Cruz y/o October PNA No: 039329 Valid Until: 39 Lifetime Member22, 2008 Labor Valid Until: December 31,2009 Date Signed: Date Signed: Gravida 2 Parity 1 Pregnancy Uterine38 2/7 4 879 Elsie CapIillo 23 y/o October 28, 2008 weeks Age of Gestation Cephalic in Labor
Time of Delivery
Gender of the Baby
Name of Hospital
Type of Delivery
CONCURRED BY: NOTED BY: Dr. Paulino J. Garcia Memorial 4: 34 pm Girl Normal Spontaneous Delivery Research and Medical Center MS. BIENVENIDA R. CAPULE MS. EPPIE DC. BUGARIN CHIEF NURSE DEAN, COLLEGE OF NURSING Dr. Paulino J. Garcia Memorial Research and Degree: Bachelor of Science in Nursing Medical Center Dr. Paulino J. Garcia MemorialRegistered Nurse 8:13pm BachelorBoy Normal Spontaneous Delivery Degree: of Science Research in Nursingand Medical CenterRegistered Midwife Registered Nurse Master of Arts in Nursing Master of Arts in Nursing PRC No: 0085974 PRC No: 0028001 Valid Until: April 3, 2011 Dr. Paulino J. Garcia Memorial 7: 57 Until: pm MarchGirl Normal Spontaneous Delivery Valid 22, 2011 Research and Medical PNA No: 17977 Center PNA No: 7629 Valid Until: Lifetime Member Valid Until: Lifetime Member ADPCN No: 0662 Dr. Paulino J. Garcia Memorial Date Signed: Valid Until: December 2009 10:15 pm Boy Normal Spontaneous Delivery Research and Medical Center Date Signed:
First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the Bachelor of Science in Nursing Program: 2005 Year Graduated (BSN Program): 2009
Republic of the Philippines NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY College of Nursing Cabanatuan City NAME OF STUDENT: SALDIVAR, FLORENCE CEREZO Name and Address of School: Nueva Ecija University of Science and Technology, Gen. Tinio St. Cabanatuan City, 3100 Accreditation Level (if any): Not Applicable Date School / Program was Recognized: December 2, 2003 No.: Board Resolution No. 96-A Year: Series of 2003 First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the Bachelor of Science in Nursing Program: 2005 Year Graduated (BSN Program): 2009
III. ASSISTED DELIVERIS No .
Case No.
Diagnosis
Name of Patient
Age
Date of Delivery
Time of Delivery
Gender of the Baby
Name of Hospital
Type of Delivery
1
877908
Gravida 1 Parity 0 Pregnancy Uterine 38 weeks Age of Gestation Cephalic in Labor
Rosalyn Romasanta
30 y/o
October 20, 2008
5: 53 pm
Girl
Dr. Paulino J. Garcia Memorial Research and Medical Center
Normal Spontaneous Delivery
2
880287
Gravida 2 Parity 1 Pregnancy Uterine 32 weeks Preterm in Labor
Rosalie dela Cruz
23 y/o
October 28, 2008
11:05 pm
Girl
Dr. Paulino J. Garcia Memorial Research and Medical Center
Normal Spontaneous Delivery
3
879212
Gravida 1 Parity 0 Pregnancy Uterine Full Term Cephalic in Labor
Joan Mercado
25 y/o
October 22, 2008
3: 00 pm
Girl
Dr. Paulino J. Garcia Memorial Research and Medical Center
Normal Spontaneous Delivery
4
879274
Gravida 2 Parity 1 Pregnancy Uterine Full Term Cephalic in Labor
Lulu Gutierrez
32 y/o
October 22, 2008
9: 25 pm
Boy
Dr. Paulino J. Garcia Memorial Research and Medical Center
Normal Spontaneous Delivery
PREPARED BY:
SUPERVISED BY:
NOTED BY:
CONCURRED BY:
NOTED BY:
FLORENE C. SALDIVAR NAME OF STUDENT Date Signed:
MS. LAENELLE V. ABERGAS Degree: Bachelor of Science in Nursing Registered Nurse 9 Units Master of Arts in Nursing PRC No: 0423121 Valid Until: October 15,2010 PNA No: 039329 Valid Until: December 31,2009 Date Signed:
MS. LUZVIMINDA I. DALLO RLE COORDINATOR Degree: Bachelor of Science in Nursing Registered Nurse Master of Arts in Nursing PRC No: 0086572 Valid Until: August 19, 2010 PNA No: 19755 Valid Until: Lifetime Member Date Signed:
MS. BIENVENIDA R. CAPULE CHIEF NURSE Dr. Paulino J. Garcia Memorial Research and Medical Center Degree: Bachelor of Science in Nursing Registered Nurse Master of Arts in Nursing PRC No: 0028001 Valid Until: March 22, 2011 PNA No: 7629 Valid Until: Lifetime Member Date Signed:
MS. EPPIE DC. BUGARIN DEAN, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Registered Nurse Registered Midwife Master of Arts in Nursing PRC No: 0085974 Valid Until: April 3, 2011 PNA No: 17977 Valid Until: Lifetime Member ADPCN No: 0662 Valid Until: December 2009 Date Signed:
Republic of the Philippines NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY College of Nursing Cabanatuan City NAME OF STUDENT: SALDIVAR, FLORENCE CEREZO Name and Address of School: Nueva Ecija University of Science and Technology, Gen. Tinio St. Cabanatuan City, 3100 Accreditation Level (if any): Not Applicable Date School / Program was Recognized: December 2, 2003 No.: Board Resolution No. 96-A Year: Series of 2003 First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the Bachelor of Science in Nursing Program: 2005 Year Graduated (BSN Program): 2009
IV. Actual Delivery No .
Case No.
Diagnosis
Name of Patient
Age
Date of Delivery
Time of Delivery
Gender of the Baby
Name of Hospital
Type of Delivery
1
217603
Gravida 1 Parity 2 Pregnancy Uterine Full Term Cephalic in Labor
Marivic Tolentino Agua
18
December 18, 2008
5:25 pm
Boy
Gapan District Hospital
Normal Spontaneous Delivery
PREPARED BY:
SUPERVISED BY:
CONCURRED BY:
NOTED BY:
NOTED BY:
MS. LUZVIMINDA I. DALLO RLE COORDINATOR, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Master of Arts in Nursing PRC No: 0086572 Valid Until: August 19, 2010 PNA No: 19755 Valid Until: Lifetime Member Date Signed:
FLORENE C. SALDIVAR NAME OF STUDENT Date Signed:
MS. EPPIE DC. BUGARIN DEAN, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Registered Midwife Master of Arts in Nursing PRC No: 0085974 Valid Until: April 3, 2011 PNA No: 17977 Valid Until: Lifetime Member ADPCN No: 0662 Valid Until: December 2009 Date Signed:
Republic of the Philippines NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY College of Nursing Cabanatuan City NAME OF STUDENT: SALDIVAR, FLORENCE CEREZO Name and Address of School: Nueva Ecija University of Science and Technology, Gen. Tinio St. Cabanatuan City, 3100 Accreditation Level (if any): Not Applicable Date School / Program was Recognized: December 2, 2003 No.: Board Resolution No. 96-A Year: Series of 2003 First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the Bachelor of Science in Nursing Program: 2005 Year Graduated (BSN Program): 2009 IV. Delivery Assisted No .
Case No.
Diagnosis
Name of Patient
Age
Date of Delivery
Time of Delivery
Gender of the Baby
Name of Hospital
Type of Delivery
1
220811
Gravida 6 Parity 5 Pregnancy Uterine Full Term Cephalic in Labor
Teresita Reyes Mustapha
41
January 22, 2009
9:36 am
Girl
Gapan District Hospital
Normal Spontaneous Delivery
PREPARED BY: FLORENE C. SALDIVAR NAME OF STUDENT Date Signed:
SUPERVISED BY:
NOTED BY:
CONCURRED BY:
MS. LUZVIMINDA I. DALLO RLE COORDINATOR, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Master of Arts in Nursing PRC No: 0086572 Valid Until: August 19, 2010 PNA No: 19755 Valid Until: Lifetime Member Date Signed:
Republic of the Philippines NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY College of Nursing Cabanatuan City
NAME OF STUDENT: SALDIVAR, FLORENCE CEREZO Name and Address of School: Nueva Ecija University of Science and Technology, Gen. Tinio St. Cabanatuan City, 3100 Accreditation Level (if any): Not Applicable Date School / Program was Recognized: December 2, 2003 No.: Board Resolution No. 96-A Year: Series of 2003 First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the Bachelor of Science in Nursing Program: 2005 Year Graduated (BSN Program): 2009
NOTED BY: MS. EPPIE DC. BUGARIN DEAN, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Registered Midwife Master of Arts in Nursing PRC No: 0085974 Valid Until: April 3, 2011 PNA No: 17977 Valid Until: Lifetime Member ADPCN No: 0662 Valid Until: December 2009 Date Signed:
PREPARED BY:
SUPERVISED BY:
NOTED BY:
CONCURRED BY:
APPROVED BY:
FLORENCE C. SALDIVAR NAME OF STUDENT Date Signed:
JENNIFER G. SAN PEDRO, RN, CLINICAL INSTRUCTOR Degree: Bachelor of Science in Nursing 18 Units Master of Arts in Nursing PRC No: 0525719 Valid Until: August 26, 2010 PNA No: 01375 Valid Until: December 31, 2009 Date Signed:
LUZVIMINDA I. DALLO, RN, MAN RLE COORDINATOR, COLLEGE OF NURSING Degree: Bachelor of Science in Nursing Master of Arts in Nursing PRC No: 0086572 Valid Until: August 19, 2010 PNA No: 19755 Valid Until: Lifetime Member Date Signed:
ALEXANDER P. MALUBAG, RN, MAN CHIEF NURSE, ELJ Degree: Bachelor of Science in Nursing Master of Arts in Nursing PRC No: 00119925 Valid Until: December 1, 2011 PNA No: 11108 Valid Until: Life Time Member Date Signed:
EPPIE DC. BUGARIN RM, RN, MAN DEAN, COLLEGE OF NURSING Degree: BSN, RM, RN, MAN PRC No: 0085974 Valid Until: April 3, 2011 PNA No: 17977 Valid Until: Lifetime Member ADCPN No: 0662 Valid Until: December 2009 Date Signed:
I. MAJOR SCRUBS No .
Date Perform
Case No.
Name of Patient
Diagnosis
1.
July 6, 2008
2991
Analyn Serrano Salazar
Pregnancy Uterine 39 weeks Age of Gestation
2.
December 5, 2008
5653
Daisy Calanday Alvaran
Gravida 1 Parity 0 Pregnancy Uterine 38 weeks Aga of Gestation Cephalic Borderline
Operation Performed
Type of Anesthesia
Name of Surgeon
Name of Hospital
Lower Cervical Caesarean Section/ Baby Girl
Spinal Anesthesia
Dr. Reyes
Euardo L. Joson Memorial Hospital
Lower Cervical Caesarean Section I
Spinal Anesthesia
Dr. Hudencial
Euardo L. Joson Memorial Hospital
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