Prc Form- Delivery Cases
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PROFESSIONAL REGULATION COMMISSION Manila BOARD OF MIDWIFERY RECORD OF DELIVERIES HANDLED
Name of Applicant:_ ALLAN O. DIMAANO, RN, MAN
Name of Patient
School: GOLDEN GATE COLLEGES
Address
Date
Name of Hospital
Hospital Case Number
Libjo, Central, Batangas City
6/2/2008
Batangas City Maternity House and Puericulture Center (BCMHPC)
08-186
6/3/2008
BCMHPC
08-193
6/4/2008
BCMHPC
08-194
6/11/2008
BCMHPC
08-205
1
Eden Marasigan
2
Jocelyn Bentillo
3
Marisol Melo
4
Eugenia Maralit
5
Mildred de Castro
Calicanto, Bats. City
6/14/2008
BCMHPC
08-210
6
Melody Fajilan
Alangilan, Bats. City
7/2/2008
BCMHPC
08-234
7
Jane Castaño Jacqueline Marasigan Mayeth Hernandez
Kumitang Ilaya, Bats. City
7/6/2008
BCMHPC
08-243
Ambulong, Bats. City
7/6/2008
BCMHPC
08-244
Calicanto, Bats. City
7/12/2008
BCMHPC
08-250
Lineth Rivera Mary Joyce Santiago
Sta. Clara, Batangas City Pallocan West, Batangas City Libjo, Tacad Batangas City Puyo, Sta. Clara, Bats. City
7/24/2008
BCMHPC
08-256
8/2/2008
BCMHPC
08-267
8/15/2008
BCMHPC
08-205
8/22/2008
BCMHPC
08-296
Ambulong, Bats. City
8/23/2008
BCMHPC
08-303
Tulo, Bats. City
9/1/2008
BCMHPC
08-311
Tierra Verde, Bats. City St. Paul Subd., Alangilan, Bats. City
9/7/2008
BCMHPC
08-322
9/10/2008
BCMHPC
08-325
San Isidro, Bats. City
9/10/2008
BCMHPC
08-327
San Pascual, Batangas
10/6/2008 10/18/200 8
BCMHPC
08-358
BCMHPC
08-375
8 9 1 0 1 1 1 2 1 3 1 4 1 5 1 6 1 7 1 8 1 9 2 0
Karen Blando Ruth Mendoza Leah Cortez Ivy Lucero Joane Manalo Anabel Cabaluna Arlene Baxa Rechelle Macuha Vergie Toralba
Ambulong, Bats. City Pob. San Pascual, Batangas Mañorez, Gwenhawa, Taysan, Batangas
Cuta, Bats. City
Check if Home Deliver y
Supervised by: The Faculty Name in Print Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas
Signatur e
Designati on
Reg. No.
RN, RM
13864 7
RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM
13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7
Name of Patient (Sutures)
Arlene 1 Carandang 2 Jocelyn Catilo Mylene 3 Villano Maricar 4 Borbon Michelle 5 Deliso
Name of Patient (Intravenous Injections)
Jean 1 Dacemon Maricel 2 Palmes Edith 3 Macaraig 4 Sheryl Culla Melody 5 Fronda
Address
Tabangao Sitio, Berberabe, Bats. City Pallocan West, Bats .City Cuta, Batangas City San Isidro, Bats. City Bilogo, Bats. City
Address
Libjo, Lamao, Bats. City Tingloy, Batangas City Paharang East, Bats. City Gulod Itaas, Bats. City Ambulong, Bats. City
Date
Name of Hospital
Hospita l Case Number
6/4/2008
BCMHPC
08-196
6/5/2008 6/12/200 8 6/24/200 8 6/24/200 8
BCMHPC
08-198
BCMHPC
08-206
BCMHPC
08-220
BCMHPC
08-221
Date
Name of Hospital
7/3/200 8 7/3/200 8 7/4/200 8 7/4/200 8 8/1/200 8
Hospita l Case Number
BCMHPC
08-235
BCMHPC
08-236
BCMHPC
08-241
BCMHPC
08-242
BCMHPC
08-265
Check if Home Deliver y
Check if Home Deliver y
Supervised by: The Faculty Name in Print
Signatur e
Designati on
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
His/her Residence Certificate No. _________ issued at ___________ on ____________ .
AFFIX DOCUMENTARY
13864 7 13864 7 13864 7 13864 7 13864 7
Supervised by: The Faculty Name in Print
Signatur e
Designati on
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
SUBSCRIBED AND SWORN TO before me this ___________ at ____________ affiant exhibiting to me
Reg. No.
CERTIFIED CORRECT:
STAMP
CATALINA M. CABANAS, RM, RN
Reg. No. 13864 7 13864 7 13864 7 13864 7 13864 7
ADMINISTRATOR ____________________ Notary Public
Name of Applicant:_ ALLAN O. DIMAANO, RN, MAN
Name of Patient
School: GOLDEN GATE COLLEGES
Address
Date
Name of Hospital
Hospital Case Number
Libjo, Central, Batangas City
6/2/2008
Batangas City Maternity House and Puericulture Center (BCMHPC)
08-186
6/3/2008
BCMHPC
08-193
6/4/2008
BCMHPC
08-194
6/11/2008
BCMHPC
08-205
1
Eden Marasigan
2
Jocelyn Bentillo
3
Marisol Melo
4
Eugenia Maralit
5
Mildred de Castro
Calicanto, Bats. City
6/14/2008
BCMHPC
08-210
6
Melody Fajilan
Alangilan, Bats. City
7/2/2008
BCMHPC
08-234
7
Jane Castaño Jacqueline Marasigan Mayeth Hernandez
Kumitang Ilaya, Bats. City
7/6/2008
BCMHPC
08-243
Ambulong, Bats. City
7/6/2008
BCMHPC
08-244
Calicanto, Bats. City
7/12/2008
BCMHPC
08-250
Lineth Rivera Mary Joyce Santiago
Sta. Clara, Batangas City Pallocan West, Batangas City Libjo, Tacad Batangas City Puyo, Sta. Clara, Bats. City
7/24/2008
BCMHPC
08-256
8/2/2008
BCMHPC
08-267
8/15/2008
BCMHPC
08-205
8/22/2008
BCMHPC
08-296
Ambulong, Bats. City
8/23/2008
BCMHPC
08-303
Tulo, Bats. City
9/1/2008
BCMHPC
08-311
Tierra Verde, Bats. City St. Paul Subd., Alangilan, Bats. City
9/7/2008
BCMHPC
08-322
9/10/2008
BCMHPC
08-325
San Isidro, Bats. City
9/10/2008
BCMHPC
08-327
San Pascual, Batangas
10/6/2008 10/18/200 8
BCMHPC
08-358
BCMHPC
08-375
8 9 1 0 1 1 1 2 1 3 1 4 1 5 1 6 1 7 1 8 1 9 2 0
Karen Blando Ruth Mendoza Leah Cortez Ivy Lucero Joane Manalo Anabel Cabaluna Arlene Baxa Rechelle Macuha Vergie Toralba
Ambulong, Bats. City Pob. San Pascual, Batangas Mañorez, Gwenhawa, Taysan, Batangas
Cuta, Bats. City
Check if Home Deliver y
Supervised by: The Faculty Name in Print Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas Catalina M. Cabañas
Signatur e
Designati on
Reg. No.
RN, RM
13864 7
RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM RN, RM
13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7 13864 7
Name of Patient (Sutures)
Arlene 1 Carandang 2 Jocelyn Catilo Mylene 3 Villano Maricar 4 Borbon Michelle 5 Deliso
Name of Patient (Intravenous Injections)
Jean 1 Dacemon Maricel 2 Palmes Edith 3 Macaraig 4 Sheryl Culla Melody 5 Fronda
Address
Tabangao Sitio, Berberabe, Bats. City Pallocan West, Bats .City Cuta, Batangas City San Isidro, Bats. City Bilogo, Bats. City
Address
Libjo, Lamao, Bats. City Tingloy, Batangas City Paharang East, Bats. City Gulod Itaas, Bats. City Ambulong, Bats. City
Date
Name of Hospital
Hospita l Case Number
6/4/2008
BCMHPC
08-196
6/5/2008 6/12/200 8 6/24/200 8 6/24/200 8
BCMHPC
08-198
BCMHPC
08-206
BCMHPC
08-220
BCMHPC
08-221
Date
Name of Hospital
7/3/200 8 7/3/200 8 7/4/200 8 7/4/200 8 8/1/200 8
Hospita l Case Number
BCMHPC
08-235
BCMHPC
08-236
BCMHPC
08-241
BCMHPC
08-242
BCMHPC
08-265
Check if Home Deliver y
Check if Home Deliver y
Supervised by: The Faculty Name in Print
Signatur e
Designati on
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
His/her Residence Certificate No. _________ issued at ___________ on ____________ .
AFFIX DOCUMENTARY
13864 7 13864 7 13864 7 13864 7 13864 7
Supervised by: The Faculty Name in Print
Signatur e
Designati on
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
Catalina M. Cabañas
RN, RM
SUBSCRIBED AND SWORN TO before me this ___________ at ____________ affiant exhibiting to me
Reg. No.
CERTIFIED CORRECT:
STAMP
CATALINA M. CABANAS, RM, RN
Reg. No. 13864 7 13864 7 13864 7 13864 7 13864 7
ADMINISTRATOR ____________________ Notary Public
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