Our Lady Of Fatima University #1 Esperanza St. Hilltop Mansion
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OUR LADY OF FATIMA UNIVERSITY #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Name of Student: GARCIA, JAMIE LYNN CARTAGENA Name and Address of School: Our Lady Of Fatima University; #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Accreditation Level (if any): PACU COA Level - II Year Granted: April 10, 2002 Date School/Program was Recognized: April 25, 2001 Number: 033 . Year: 2001 First Course (if any) : NOT APPLICABLE School Graduated From: NOT APPLICABLE Year: NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2004 Year Graduated (BSN Program): ______________________________________________________________________________________________________________________________________
.
.
.
.
.
.
I. Major Operations Name of Patient
Diagnosis
Operation Performed
Type of Anesthesia
Name of Surgeon
Name of Hospital
Name of Qualified CI
09000012280
Bautista, Clara Pedrosa
Mature Senile Cataract Left Eye
Phacoemulsification with Posterior Chamber Intraocular Lens Left Eye
Monitored Anesthesia Care
Dr. Jonathan Dominic Feliciano
Fatima University Medical Center
Secinia I. Tallo RN, RM, MAN
March 19, 2009
090000123038
Gabito, Reynante
Ruptured Appendix
Appendectomy
Spinal Anesthesia
Dr. James Taclin Bañez
Fatima University Medical Center
Secinia I. Tallo RN, RM, MAN
3.
June 11, 2009
06080968
Imperial, Hilaria Ponce
Mature Senile Cataract Right Eye
Phacoemulsification with Posterior Chamber Intraocular Lens Right Eye
Monitored Anesthesia Care
Dr. Guillermo Loja
Fatima Eye And Rehabilitation Center
Arvin A. Aculana RN, MAN
4.
October 27, 2009
01021
Dionela, Annabel Non
Gravida 2 Para 1 Pregnancy Uterine Full Term 37 Weeks And 5 Days Age of Gestation Not In Labor
Low Transverse Cesarian Section
Spinal Anesthesia
Dr. Emily Fernando
Balagtas Doctors Hospital
Wilowena Angeles RN, MAN
5.
October 27, 2009
01024
Pepito, Asuncion Dagohoy
Mature Senile Cataract Right Eye
Cataract Extraction Right Eye
Monitored Anesthesia Care
Dr. Ronaldo Fernando
Balagtas Doctors Hospital
Wilowena Angeles RN, MAN
Date of Operation
Case No.
1.
March 12, 2009
2.
No.
Prepared by:
Noted by:
GARCIA, JAMIE LYNN C__________. Signature over printed Name of Student
MARISOL GARCIA – MANIPOL RN, MAN
Supervised by: _______________ Signature over printed name of Faculty Date Signed: ____________ Degree: ________________ a.) PRC NO: __________ Valid Until: ________ b.) PNA NO: _________ Valid Until: ___________
Signature over printed name of Clinical Coordinator Date Signed: _____________________ Degree: BSN, MAN PRC NO: 0296870 Valid Until: September 2012__ b.) PNA NO: ___________ Valid Until:_________ .
.
Concurred by: MYLENE BERNADETTE O. SANTOS RN, MAN, MD
Signature over printed name of Chief Nurse Date Signed: ___________ Degree: _BSN, MD, MAN_____ PRC NO: _0192913____ Valid Until: _February 28, 2013_ b.) PNA NO: ___________ Valid Until: _________
Signature of Qualified CI
Approved by:
Concurred by: LORNA PUNONGBAYAN DIANO RN
Signature over printed name of Chief Nurse Date Signed: ___________ Degree: _RN______________ PRC NO:0260345 Valid Until: _March 21, 2013 b.) PNA NO: ___________ Valid Until: _________ .
NELIA R. CAPULONG RN, RM, MAN Signature over printed Name of Dean Date Signed: ____________ Degree: BSN, RM, MAN____ a.) PRC NO: _0041904____ Valid Until: _July 31, 2012__ b.) PNA NO: _18698_____ Valid Until: _LIFETIME____ ADPCN NO: _0627___ Valid Until: __________
OUR LADY OF FATIMA UNIVERSITY #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Name of Student: GARCIA, JAMIE LYNN CARTAGENA _ . Name and Address of School: Our Lady Of Fatima University; #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Accreditation Level (if any): PACU COA Level - II Year Granted: April 10, 2002 Date School/Program was Recognized: April 25, 2001 Number: 033 . Year: 2001 First Course (if any) : NOT APPLICABLE School Graduated From: NOT APPLICABLE Year: NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2004 Year Graduated (BSN Program): ____________________________________________________________________________________________________________________________________________ .
.
.
.
.
I. Minor Operations No. Date of Operation
Case No.
Name of Patient
Diagnosis
Operation Performed
Type of Anesthesia
Name of Surgeon
Name of Hospital
Name of Qualified CI
1.
April 8, 2009
011245
Haban, Rondolf
Phemosis
Circumcision
Local Anesthesia
Dr. Jose Antonio
Novaliches District Hospital
Rosanie C. Moro RN, PhD
2.
April 16, 2009
1775519
De Lava, Hansley
Abscess Left Frontal Area
Incision And Drainage
Dr. Libunao
Novaliches District Hospital
Rosanie C. Moro RN, PhD
3.
4.
5.
Signature of Qualified CI
Prepared by:
Noted by:
GARCIA, JAMIE LYNN C__________. Signature over printed Name of Student
MARISOL GARCIA – MANIPOL RN, MAN
Supervised by:
Signature over printed name of Clinical Coordinator Date Signed: _____________________ Degree: BSN, MAN PRC NO: 0296870 Valid Until: September 2012__ b.) PNA NO: ___________ Valid Until:_________ .
_______________ Signature over printed name of Faculty Date Signed: ____________ Degree: ________________ a.) PRC NO: __________ Valid Until: ________ b.) PNA NO: _________ Valid Until: ___________
.
Concurred by:
Concurred by:
Approved by:
JOSEPHINE B. LEONARDO RN, PhD Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_BSN, MAN, PhD___ PRC NO: _0081174___ Valid Until: _April 3, 2013___ b.) PNA NO: _15614___ Valid Until: _LIFETIME____
___________________________ Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_______________ PRC NO: __________ Valid Until: ____________ b.) PNA NO: ___________ Valid Until: _________
NELIA R. CAPULONG RN, RM, MAN Signature over printed Name of Dean Date Signed: ____________ Degree: BSN, RM, MAN____ a.) PRC NO: _0041904____ Valid Until: _July 31, 2012__ b.) PNA NO: _18698_____ Valid Until: _LIFETIME____ ADPCN NO: _0627___ Valid Until: __________
OUR LADY OF FATIMA UNIVERSITY #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Name of Student: GARCIA, JAMIE LYNN CARTAGENA Name and Address of School: Our Lady Of Fatima University; #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Accreditation Level (if any): PACU COA Level - II Year Granted: April 10, 2002 Date School/Program was Recognized: April 25, 2001 Number: 033 . Year: 2001 First Course (if any) : NOT APPLICABLE School Graduated From: NOT APPLICABLE Year: NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2004
.
.
.
.
.
.
I. Actual Deliveries No.
Supervised by: Signature of Qualified CI
Case No.
Diagnosis
Name of Mother
Age
Date of Delivery
Time of Delivery
Gender of Baby
Name of Hospital
Type of Delivery
1.
09-8329
Gravida 1 Para 0 Pregnancy Uterine Full Term Cephalic In Labor
Rosales, Jermanie Masangkay
22
August 3, 2009
2:28 AM
Girl
San Jose District Hospital
Forcep Delivery
Rosalinda L. Flores RN, MAN PRC NO: 0082223 PNA NO:
2.
421850
Gravida 1 Para 0 Pregnancy Uterine Full Term 39 Weeks and 4 Days Age Of Gestation Cephalic In Labor
Sangalong, Jocelyn
20
September 16, 2009
8:44 PM
Girl
Batangas Regional Hospital
Normal Spontaneous Delivery
Gonzala De Mesa RN, MAN
3.
421936
Gravida 4 Para 3 Pregnancy Uterine Full Term 41 Weeks and 1 Day Age Of Gestation Cephalic In Labor
Magpantay, Maria Carmina
34
September 18, 2009
9:16 PM
Boy
Batangas Regional Hospital
Normal Spontaneous Delivery
Gonzala De Mesa RN, MAN
4.
422188
Colis, Rodelyn
32
September 19, 2009
12:38 AM
Boy
Batangas Regional Hospital
Normal Spontaneous Delivery
Gonzala De Mesa RN, MAN
5.
Gravida 3 Para 2 Pregnancy Uterine Full Term 38 Weeks and 1 Day Age Of Gestation Cephalic In Labor
Year Graduated (BSN Program): _______________________________________________________________________________________ Prepared by:
Noted by:
GARCIA, JAMIE LYNN C__________. Signature over printed Name of Student
MARISOL GARCIA – MANIPOL RN, MAN
Supervised by:
Signature over printed name of Clinical Coordinator Date Signed: _____________________ Degree: BSN, MAN PRC NO: 0296870 Valid Until: September 2012__ b.) PNA NO: ___________ Valid Until:_________ .
_______________ Signature over printed name of Faculty Date Signed: ____________ Degree: ________________ a.) PRC NO: __________ Valid Until: ________ b.) PNA NO: _________ Valid Until: ___________
.
________________
__________
Concurred by: Concurred by: ROSALINDA L. FLORES RN, MAN Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_BSN, MAN______ PRC NO: _0082223_____ Valid Until: _November 25, 2011 b.) PNA NO: ___________ Valid Until: _________
AMOR CALAYAN RN, RM, MAN,PhD Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_ BSN, RM, MAN,PhD ___ PRC NO: _151514___ Valid Until: _August 2013____ b.) PNA NO: ___________ Valid Until: _________ c.) ANSAP NO: ______________ Valid Until:_______________
Approved by: NELIA R. CAPULONG RN, RM, MAN Signature over printed Name of Dean Date Signed: ____________ Degree: BSN, RM, MAN____ a.) PRC NO: _0041904____ Valid Until: _July 31, 2012__ b.) PNA NO: _18698_____ Valid Until: _LIFETIME____ ADPCN NO: _0627___ Valid Until: __________
OUR LADY OF FATIMA UNIVERSITY #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Name of Student: GARCIA, JAMIE LYNN CARTAGENA Name and Address of School: Our Lady Of Fatima University; #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Accreditation Level (if any): PACU COA Level - II Year Granted: April 10, 2002 Date School/Program was Recognized: April 25, 2001 Number: 033 . Year: 2001 First Course (if any) : NOT APPLICABLE School Graduated From: NOT APPLICABLE Year: NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2004 Year Graduated (BSN Program): ___________________________________________________________
.
.
.
.
.
.
.
IV. Deliveries Assisted No.
Case No.
Diagnosis
Name of Mother
Age
Date of Delivery
Time of Delivery
Gender of Baby
Name of Hospital
Type of Delivery
Supervised by: Signature of Qualified C.I.
08-3249
Gravida 1 Para 0 39 Weeks Age of Gestation Cephalic In Labor
Remo, Rochelle
31
August 1, 2009
2:14 PM
Boy
San Jose District Hospital
Normal Spontaneous Delivery
Rosalinda L. Flores RN, MAN PRC NO: 0082223 PNA NO:
08-1610
Gravida 1, Para 0 Pregnancy Uterine 37-38 Weeks Age Of Gestation Cephalic In Labor
Cuasay, Rose Ann
21
July 30, 2009
6:58 PM
Boy
San Jose District Hospital
Normal Spontaneous Delivery
Rosalinda L. Flores RN, MAN PRC NO: 0082223 PNA NO:
Lacdang, April
18
September 16, 2009
8:05 AM
Boy
Batangas Regional Hospital
Normal Spontaneous Delivery
Gonzala De Mesa RN, MAN
1.
2.
3. 420394 4.
Gravida 1, Para 0 Pregnancy Uterine 38 Weeks and 2 Days Age Of Gestation Cephalic In Labor
5.
Prepared by:
Noted by:
GARCIA, JAMIE LYNN C__________. Signature over printed Name of Student
MARISOL GARCIA – MANIPOL RN, MAN
Supervised by:
Concurred by: Concurred by:
Signature over printed name of Clinical Coordinator Date Signed: _____________________ Degree: BSN, MAN PRC NO: 0296870 Valid Until: September 2012__ b.) PNA NO: ___________ Valid Until:_________
ROSALINDA L. FLORES RN, MAN Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_BSN, MAN______ PRC NO: _0082223_____ Valid Until: _November 25, 2011 b.) PNA NO: ___________ Valid Until: _________
.
_______________ Signature over printed name of Faculty Date Signed: ____________ Degree: ________________ a.) PRC NO: __________ Valid Until: ________ b.) PNA NO: _________ Valid Until: ___________
.
AMOR CALAYAN RN, RM, MAN,PhD Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_ BSN, RM, MAN,PhD ___ PRC NO: _151514___ Valid Until: _August 2013____ b.) PNA NO: ___________ Valid Until: _________ c.) ANSAP NO: ______________ Valid Until:_______________
Approved by: NELIA R. CAPULONG RN, RM, MAN Signature over printed Name of Dean Date Signed: ____________ Degree: BSN, RM, MAN____ a.) PRC NO: _0041904____ Valid Until: _July 31, 2012__ b.) PNA NO: _18698_____ Valid Until: _LIFETIME____ ADPCN NO: _0627___ Valid Until: __________
OUR LADY OF FATIMA UNIVERSITY #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Name of Student: GARCIA, JAMIE LYNN CARTAGENA Name and Address of School: Our Lady Of Fatima University; #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Accreditation Level (if any): PACU COA Level - II Year Granted: April 10, 2002 Date School/Program was Recognized: April 25, 2001 Number: 033 . Year: 2001 First Course (if any) : NOT APPLICABLE School Graduated From: NOT APPLICABLE Year: NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2004 Year Graduated (BSN Program): ______________________________
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.
.
.
.
.
.
V. Cord Dressing No.
Case No.
Date Performed
Name of Baby
Gender of Baby
Name of Mother
Age
Name of Hospital
Supervised by: Signature of Qualified C.I.
1.
09-10-466
July 31, 2009
Baby Boy Ocampo
Boy
Ocampo, Maricel
25
San Jose District Hospital
Rosalinda L. Flores RN, MAN PRC NO: 0082223 PNA NO:
2.
09-10-433
July 31, 2009
Baby Boy Liwanag
Boy
Liwanag, Maylin
20
San Jose District Hospital
3.
4.
Rosalinda L. Flores RN, MAN PRC NO: 0082223 PNA NO:
5.
Prepared by:
Noted by:
Concurred by:
Concurred by:
Approved by:
GARCIA, JAMIE LYNN C__________. Signature over printed Name of Student
MARISOL GARCIA – MANIPOL RN, MAN
ROSALINDA L. FLORES RN, MAN Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_BSN, MAN______ b.) PRC NO: _0082223_____ Valid Until: _November 25, 2011 b.) PNA NO: ___________ Valid Until: _________
______________________________ Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_______________ a.) PRC NO: __________ Valid Until: ____________ b.) PNA NO: ___________ Valid Until: _________
NELIA R. CAPULONG RN, RM, MAN Signature over printed Name of Dean Date Signed: ____________ Degree: BSN, RM, MAN____ a.) PRC NO: _0041904____ Valid Until: _July 31, 2012__ b.) PNA NO: _18698_____ Valid Until: _LIFETIME____ b.)ADPCN NO: _0627___ Valid Until: __________
Supervised by: _______________ Signature over printed name of Faculty Date Signed: ____________ Degree: ________________ a.) PRC NO: __________ Valid Until: ________ b.) PNA NO: _________ Valid Until: ___________
Signature over printed name of Clinical Coordinator Date Signed: _____________________ Degree: BSN, MAN a.)_PRC NO: 0296870 Valid Until: September 2012__ b.) PNA NO: ___________ Valid Until:_________ .
.
.
.
.
.
.
.
I. Major Operations Name of Patient
Diagnosis
Operation Performed
Type of Anesthesia
Name of Surgeon
Name of Hospital
Name of Qualified CI
09000012280
Bautista, Clara Pedrosa
Mature Senile Cataract Left Eye
Phacoemulsification with Posterior Chamber Intraocular Lens Left Eye
Monitored Anesthesia Care
Dr. Jonathan Dominic Feliciano
Fatima University Medical Center
Secinia I. Tallo RN, RM, MAN
March 19, 2009
090000123038
Gabito, Reynante
Ruptured Appendix
Appendectomy
Spinal Anesthesia
Dr. James Taclin Bañez
Fatima University Medical Center
Secinia I. Tallo RN, RM, MAN
3.
June 11, 2009
06080968
Imperial, Hilaria Ponce
Mature Senile Cataract Right Eye
Phacoemulsification with Posterior Chamber Intraocular Lens Right Eye
Monitored Anesthesia Care
Dr. Guillermo Loja
Fatima Eye And Rehabilitation Center
Arvin A. Aculana RN, MAN
4.
October 27, 2009
01021
Dionela, Annabel Non
Gravida 2 Para 1 Pregnancy Uterine Full Term 37 Weeks And 5 Days Age of Gestation Not In Labor
Low Transverse Cesarian Section
Spinal Anesthesia
Dr. Emily Fernando
Balagtas Doctors Hospital
Wilowena Angeles RN, MAN
5.
October 27, 2009
01024
Pepito, Asuncion Dagohoy
Mature Senile Cataract Right Eye
Cataract Extraction Right Eye
Monitored Anesthesia Care
Dr. Ronaldo Fernando
Balagtas Doctors Hospital
Wilowena Angeles RN, MAN
Date of Operation
Case No.
1.
March 12, 2009
2.
No.
Prepared by:
Noted by:
GARCIA, JAMIE LYNN C__________. Signature over printed Name of Student
MARISOL GARCIA – MANIPOL RN, MAN
Supervised by: _______________ Signature over printed name of Faculty Date Signed: ____________ Degree: ________________ a.) PRC NO: __________ Valid Until: ________ b.) PNA NO: _________ Valid Until: ___________
Signature over printed name of Clinical Coordinator Date Signed: _____________________ Degree: BSN, MAN PRC NO: 0296870 Valid Until: September 2012__ b.) PNA NO: ___________ Valid Until:_________ .
.
Concurred by: MYLENE BERNADETTE O. SANTOS RN, MAN, MD
Signature over printed name of Chief Nurse Date Signed: ___________ Degree: _BSN, MD, MAN_____ PRC NO: _0192913____ Valid Until: _February 28, 2013_ b.) PNA NO: ___________ Valid Until: _________
Signature of Qualified CI
Approved by:
Concurred by: LORNA PUNONGBAYAN DIANO RN
Signature over printed name of Chief Nurse Date Signed: ___________ Degree: _RN______________ PRC NO:0260345 Valid Until: _March 21, 2013 b.) PNA NO: ___________ Valid Until: _________ .
NELIA R. CAPULONG RN, RM, MAN Signature over printed Name of Dean Date Signed: ____________ Degree: BSN, RM, MAN____ a.) PRC NO: _0041904____ Valid Until: _July 31, 2012__ b.) PNA NO: _18698_____ Valid Until: _LIFETIME____ ADPCN NO: _0627___ Valid Until: __________
OUR LADY OF FATIMA UNIVERSITY #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Name of Student: GARCIA, JAMIE LYNN CARTAGENA _ . Name and Address of School: Our Lady Of Fatima University; #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Accreditation Level (if any): PACU COA Level - II Year Granted: April 10, 2002 Date School/Program was Recognized: April 25, 2001 Number: 033 . Year: 2001 First Course (if any) : NOT APPLICABLE School Graduated From: NOT APPLICABLE Year: NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2004 Year Graduated (BSN Program): ____________________________________________________________________________________________________________________________________________ .
.
.
.
.
I. Minor Operations No. Date of Operation
Case No.
Name of Patient
Diagnosis
Operation Performed
Type of Anesthesia
Name of Surgeon
Name of Hospital
Name of Qualified CI
1.
April 8, 2009
011245
Haban, Rondolf
Phemosis
Circumcision
Local Anesthesia
Dr. Jose Antonio
Novaliches District Hospital
Rosanie C. Moro RN, PhD
2.
April 16, 2009
1775519
De Lava, Hansley
Abscess Left Frontal Area
Incision And Drainage
Dr. Libunao
Novaliches District Hospital
Rosanie C. Moro RN, PhD
3.
4.
5.
Signature of Qualified CI
Prepared by:
Noted by:
GARCIA, JAMIE LYNN C__________. Signature over printed Name of Student
MARISOL GARCIA – MANIPOL RN, MAN
Supervised by:
Signature over printed name of Clinical Coordinator Date Signed: _____________________ Degree: BSN, MAN PRC NO: 0296870 Valid Until: September 2012__ b.) PNA NO: ___________ Valid Until:_________ .
_______________ Signature over printed name of Faculty Date Signed: ____________ Degree: ________________ a.) PRC NO: __________ Valid Until: ________ b.) PNA NO: _________ Valid Until: ___________
.
Concurred by:
Concurred by:
Approved by:
JOSEPHINE B. LEONARDO RN, PhD Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_BSN, MAN, PhD___ PRC NO: _0081174___ Valid Until: _April 3, 2013___ b.) PNA NO: _15614___ Valid Until: _LIFETIME____
___________________________ Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_______________ PRC NO: __________ Valid Until: ____________ b.) PNA NO: ___________ Valid Until: _________
NELIA R. CAPULONG RN, RM, MAN Signature over printed Name of Dean Date Signed: ____________ Degree: BSN, RM, MAN____ a.) PRC NO: _0041904____ Valid Until: _July 31, 2012__ b.) PNA NO: _18698_____ Valid Until: _LIFETIME____ ADPCN NO: _0627___ Valid Until: __________
OUR LADY OF FATIMA UNIVERSITY #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Name of Student: GARCIA, JAMIE LYNN CARTAGENA Name and Address of School: Our Lady Of Fatima University; #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Accreditation Level (if any): PACU COA Level - II Year Granted: April 10, 2002 Date School/Program was Recognized: April 25, 2001 Number: 033 . Year: 2001 First Course (if any) : NOT APPLICABLE School Graduated From: NOT APPLICABLE Year: NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2004
.
.
.
.
.
.
I. Actual Deliveries No.
Supervised by: Signature of Qualified CI
Case No.
Diagnosis
Name of Mother
Age
Date of Delivery
Time of Delivery
Gender of Baby
Name of Hospital
Type of Delivery
1.
09-8329
Gravida 1 Para 0 Pregnancy Uterine Full Term Cephalic In Labor
Rosales, Jermanie Masangkay
22
August 3, 2009
2:28 AM
Girl
San Jose District Hospital
Forcep Delivery
Rosalinda L. Flores RN, MAN PRC NO: 0082223 PNA NO:
2.
421850
Gravida 1 Para 0 Pregnancy Uterine Full Term 39 Weeks and 4 Days Age Of Gestation Cephalic In Labor
Sangalong, Jocelyn
20
September 16, 2009
8:44 PM
Girl
Batangas Regional Hospital
Normal Spontaneous Delivery
Gonzala De Mesa RN, MAN
3.
421936
Gravida 4 Para 3 Pregnancy Uterine Full Term 41 Weeks and 1 Day Age Of Gestation Cephalic In Labor
Magpantay, Maria Carmina
34
September 18, 2009
9:16 PM
Boy
Batangas Regional Hospital
Normal Spontaneous Delivery
Gonzala De Mesa RN, MAN
4.
422188
Colis, Rodelyn
32
September 19, 2009
12:38 AM
Boy
Batangas Regional Hospital
Normal Spontaneous Delivery
Gonzala De Mesa RN, MAN
5.
Gravida 3 Para 2 Pregnancy Uterine Full Term 38 Weeks and 1 Day Age Of Gestation Cephalic In Labor
Year Graduated (BSN Program): _______________________________________________________________________________________ Prepared by:
Noted by:
GARCIA, JAMIE LYNN C__________. Signature over printed Name of Student
MARISOL GARCIA – MANIPOL RN, MAN
Supervised by:
Signature over printed name of Clinical Coordinator Date Signed: _____________________ Degree: BSN, MAN PRC NO: 0296870 Valid Until: September 2012__ b.) PNA NO: ___________ Valid Until:_________ .
_______________ Signature over printed name of Faculty Date Signed: ____________ Degree: ________________ a.) PRC NO: __________ Valid Until: ________ b.) PNA NO: _________ Valid Until: ___________
.
________________
__________
Concurred by: Concurred by: ROSALINDA L. FLORES RN, MAN Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_BSN, MAN______ PRC NO: _0082223_____ Valid Until: _November 25, 2011 b.) PNA NO: ___________ Valid Until: _________
AMOR CALAYAN RN, RM, MAN,PhD Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_ BSN, RM, MAN,PhD ___ PRC NO: _151514___ Valid Until: _August 2013____ b.) PNA NO: ___________ Valid Until: _________ c.) ANSAP NO: ______________ Valid Until:_______________
Approved by: NELIA R. CAPULONG RN, RM, MAN Signature over printed Name of Dean Date Signed: ____________ Degree: BSN, RM, MAN____ a.) PRC NO: _0041904____ Valid Until: _July 31, 2012__ b.) PNA NO: _18698_____ Valid Until: _LIFETIME____ ADPCN NO: _0627___ Valid Until: __________
OUR LADY OF FATIMA UNIVERSITY #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Name of Student: GARCIA, JAMIE LYNN CARTAGENA Name and Address of School: Our Lady Of Fatima University; #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Accreditation Level (if any): PACU COA Level - II Year Granted: April 10, 2002 Date School/Program was Recognized: April 25, 2001 Number: 033 . Year: 2001 First Course (if any) : NOT APPLICABLE School Graduated From: NOT APPLICABLE Year: NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2004 Year Graduated (BSN Program): ___________________________________________________________
.
.
.
.
.
.
.
IV. Deliveries Assisted No.
Case No.
Diagnosis
Name of Mother
Age
Date of Delivery
Time of Delivery
Gender of Baby
Name of Hospital
Type of Delivery
Supervised by: Signature of Qualified C.I.
08-3249
Gravida 1 Para 0 39 Weeks Age of Gestation Cephalic In Labor
Remo, Rochelle
31
August 1, 2009
2:14 PM
Boy
San Jose District Hospital
Normal Spontaneous Delivery
Rosalinda L. Flores RN, MAN PRC NO: 0082223 PNA NO:
08-1610
Gravida 1, Para 0 Pregnancy Uterine 37-38 Weeks Age Of Gestation Cephalic In Labor
Cuasay, Rose Ann
21
July 30, 2009
6:58 PM
Boy
San Jose District Hospital
Normal Spontaneous Delivery
Rosalinda L. Flores RN, MAN PRC NO: 0082223 PNA NO:
Lacdang, April
18
September 16, 2009
8:05 AM
Boy
Batangas Regional Hospital
Normal Spontaneous Delivery
Gonzala De Mesa RN, MAN
1.
2.
3. 420394 4.
Gravida 1, Para 0 Pregnancy Uterine 38 Weeks and 2 Days Age Of Gestation Cephalic In Labor
5.
Prepared by:
Noted by:
GARCIA, JAMIE LYNN C__________. Signature over printed Name of Student
MARISOL GARCIA – MANIPOL RN, MAN
Supervised by:
Concurred by: Concurred by:
Signature over printed name of Clinical Coordinator Date Signed: _____________________ Degree: BSN, MAN PRC NO: 0296870 Valid Until: September 2012__ b.) PNA NO: ___________ Valid Until:_________
ROSALINDA L. FLORES RN, MAN Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_BSN, MAN______ PRC NO: _0082223_____ Valid Until: _November 25, 2011 b.) PNA NO: ___________ Valid Until: _________
.
_______________ Signature over printed name of Faculty Date Signed: ____________ Degree: ________________ a.) PRC NO: __________ Valid Until: ________ b.) PNA NO: _________ Valid Until: ___________
.
AMOR CALAYAN RN, RM, MAN,PhD Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_ BSN, RM, MAN,PhD ___ PRC NO: _151514___ Valid Until: _August 2013____ b.) PNA NO: ___________ Valid Until: _________ c.) ANSAP NO: ______________ Valid Until:_______________
Approved by: NELIA R. CAPULONG RN, RM, MAN Signature over printed Name of Dean Date Signed: ____________ Degree: BSN, RM, MAN____ a.) PRC NO: _0041904____ Valid Until: _July 31, 2012__ b.) PNA NO: _18698_____ Valid Until: _LIFETIME____ ADPCN NO: _0627___ Valid Until: __________
OUR LADY OF FATIMA UNIVERSITY #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Name of Student: GARCIA, JAMIE LYNN CARTAGENA Name and Address of School: Our Lady Of Fatima University; #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City Accreditation Level (if any): PACU COA Level - II Year Granted: April 10, 2002 Date School/Program was Recognized: April 25, 2001 Number: 033 . Year: 2001 First Course (if any) : NOT APPLICABLE School Graduated From: NOT APPLICABLE Year: NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2004 Year Graduated (BSN Program): ______________________________
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V. Cord Dressing No.
Case No.
Date Performed
Name of Baby
Gender of Baby
Name of Mother
Age
Name of Hospital
Supervised by: Signature of Qualified C.I.
1.
09-10-466
July 31, 2009
Baby Boy Ocampo
Boy
Ocampo, Maricel
25
San Jose District Hospital
Rosalinda L. Flores RN, MAN PRC NO: 0082223 PNA NO:
2.
09-10-433
July 31, 2009
Baby Boy Liwanag
Boy
Liwanag, Maylin
20
San Jose District Hospital
3.
4.
Rosalinda L. Flores RN, MAN PRC NO: 0082223 PNA NO:
5.
Prepared by:
Noted by:
Concurred by:
Concurred by:
Approved by:
GARCIA, JAMIE LYNN C__________. Signature over printed Name of Student
MARISOL GARCIA – MANIPOL RN, MAN
ROSALINDA L. FLORES RN, MAN Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_BSN, MAN______ b.) PRC NO: _0082223_____ Valid Until: _November 25, 2011 b.) PNA NO: ___________ Valid Until: _________
______________________________ Signature over printed name of Chief Nurse Date Signed: ___________ Degree:_______________ a.) PRC NO: __________ Valid Until: ____________ b.) PNA NO: ___________ Valid Until: _________
NELIA R. CAPULONG RN, RM, MAN Signature over printed Name of Dean Date Signed: ____________ Degree: BSN, RM, MAN____ a.) PRC NO: _0041904____ Valid Until: _July 31, 2012__ b.) PNA NO: _18698_____ Valid Until: _LIFETIME____ b.)ADPCN NO: _0627___ Valid Until: __________
Supervised by: _______________ Signature over printed name of Faculty Date Signed: ____________ Degree: ________________ a.) PRC NO: __________ Valid Until: ________ b.) PNA NO: _________ Valid Until: ___________
Signature over printed name of Clinical Coordinator Date Signed: _____________________ Degree: BSN, MAN a.)_PRC NO: 0296870 Valid Until: September 2012__ b.) PNA NO: ___________ Valid Until:_________ .
.
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