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LICEO DE CAGAYAN UNIVERSITY College of Nursing Rodolfo N. Pelaez Boulevard Kauswagan, Cagayan de Oro City
School Code: 0835
Name of Student: Name and Address of School: Recognition and Accreditation Level: Year Granted: Date when school was recognized:
ORONG, ALTHEA PAZ BALODO Liceo de Cagayan University – Rodolfo N. Pelaez Boulevard, Kauswagan, Cagayan de Oro City PACUCOA – Level III AUTONOMOUS First Course (if any): NOT APPLICABLE OCTOBER 2008 NOVEMBER 2009 School Graduated from: NOT APPLICABLE June 1972 Year of Admission in the BSN Program : 2008 Year Graduated (BSN Program) : 2012
Year: NOT APPLICABLE
I. MAJOR OPERATIONS No. 1
Date of Operation
Case No.
Name of Patient
Diagnosis
July 13, 2010
3785
Yasin, Anisah
Open Fracture Medial Third Tibia Fibula Right
September 27, 2010
763968
Ricky Llanto
2
Mandibular Fracture, depressed (right)
October 20, 2010
6085
Irene Tiu
3
Endometrial hyperplasia rule out Endometrial Carcinoma
Operation Performed
Types of Anesthesia
Name of Surgeon
Name of Hospital
Cagayan Polymedic General Hospital Northern Mindanao medial Center
Mrs. Maria Madel C. Reyes, RN
Cagayan Polymedic General Hospital
Jade Claire O. Alvarez, RN
Debridement Irrigation Open Reduction Inter-Medullary; Interlocking nail, right tibia Open Reduction Internal Fixation of depressed malar fracture using Titanium/ Orbityl plates; Open Reduction Internal Fixation of Mandiblar Fracture using Titanium plates; Mandibulomaxillary Fixation
Spinal anesthesia
Dr. Jovito Lao
General Anesthesia
Dr. Robert Gomez
Cervical punch biopsy, Fractional dilatation and curettage
Spinal Anesthesia
Dr. Jana Joy Tursalem
Name of Qualified OR Scrub Nurse
Fidelo Rey Mandawe, RN
Approved by: Prepared by:
NAME
Name and Signature of Student
Supervised by:
GINA S. BATASIN-IN
OR Clinical Instructor Liceo de Cagayan University Date Signed: _____________ Degree: BSN, RN,MN PRC No: 0157111 Valid Until: December 10, 2013 PNA No: Valid Until: October 31, 2011
Noted by:
VIVIAN L. CEBALLOS
RLE Chairperson /Clin. Coor. Liceo de Cagayan University Date Signed: ________________ Degree: BSN, RN, MAN PRC No: 0171698 Valid Until: September 7, 2014 PNA No: 17947 Valid Until: Lifetime Member
Concurred by: Concurred by:
MARIA CHONA V. PALOMARES Dean Liceo de Cagayan University Date Signed: _______________ Degree: B.S.N., M.A.N. PRC No.: 0080354 Valid Until: September 23, 2013 PNA No: 17266 Valid Until: Lifetime Member ADPCN No: ________________ Valid Until: December 31, 2011
Signature of Qualified OR Scrub Nurse
LICEO DE CAGAYAN UNIVERSITY College of Nursing Rodolfo N. Pelaez Boulevard Kauswagan, Cagayan de Oro City
School Code: 0835 Name of Student: Name and Address of School: Recognition and Accreditation Level: Year Granted: Date when school was recognized:
ORONG, ALTHEA PAZ BALODO Liceo de Cagayan University – Rodolfo N. Pelaez Boulevard, Kauswagan, Cagayan de Oro City PACUCOA – Level III AUTONOMOUS First Course (if any): NOT APPLICABLE OCTOBER 2008 NOVEMBER 2009 School Graduated from: NOT APPLICABLE June 1972 Year of Admission in the BSN Program : 2008 Year Graduated (BSN Program) : 2012
Year: NOT APPLICABLE
II. MAJOR OPERATIONS No.
Date of Operation
Case No.
Name of Patient
Operation Performed
Diagnosis
1
May 26, 2011
02679
Quilab, Glyza Shamil
Cleft lip complete
Cheiloplasty
2
December 10, 2010
210272 4
Hibaya, Vanessa Myla
3
July 5, 2010
001105
Lota Generalao
Preterm cephalic not in labor oligohydramnios delivered live baby boy with an APGAR score of 10, body weight of 10 Mature Cataract Left Eye
Low section cesarean section myomectomy Phaco emulsification of Cataract Left Eye
Types of Anesthesia
Name of Surgeon
Name of Hospital
Name of Qualified OR Circulatinhg Nurse
General Endotracheal Anesthesia Spinal Anesthesia
Dr. Veronica Abelera
Kriss Kringle Virtudes, RN
Dr. Reynaldo Chu
Cagayan Polymedic General Hospital Madonna and Child Hospital
Retrobulbar block
Dr. Carlo Antonio J. Romero
Cagayan Polymedic General Hospital
RC Ann Macaranas, RN
Signature of Qualified OR Scrub Nurse
Letecia Reyes, RN
Prepared by:
PRC FORM TEMPLATE
Name and Signature of Student
Supervised by:
GINA S. BATASIN-IN
OR Clinical Instructor Liceo de Cagayan University Date Signed: _____________ Degree: BSN, RN, MN PRC No: 0157111 Valid Until: December 10, 2013 PNA No: Valid Until: December 31, 2011
Noted by:
VIVIAN L. CEBALLOS
RLE Chairperson /Clin. Coor. Liceo de Cagayan University Date Signed: ___________ Degree: BSN, RN, MAN PRC No: 0171698 Valid Until: September 7, 2011 PNA No: 17947 Valid Until: Lifetime Member
Concurred by:
Concurred by:
Concurred by:
Approved by:
MARIA CHONA V. PALOMARES Dean Liceo de Cagayan University Date Signed: ______________ Degree: B.S.N. RN M.A.N. PRC No.: 0080354 Valid Until: September 23, 2013 PNA No: 17266 Valid Until: Lifetime Member ADPCN No: ________________ Valid Until: December 31, 2011
LICEO DE CAGAYAN UNIVERSITY College of Nursing Rodolfo N. Pelaez Boulevard Kauswagan , Cagayan de Oro City
School Code: 0835 Name of Student: Name and Address of School: Recognition and Accreditation Level: Year Granted: Date when school was recognized:
ORONG, ALTHEA PAZ BALODO Liceo de Cagayan University – Rodolfo N. Pelaez Boulevard, Kauswagan, Cagayan de Oro City PACUCOA – Level III AUTONOMOUS First Course (if any): NOT APPLICABLE OCTOBER 2008 NOVEMBER 2009 School Graduated from: NOT APPLICABLE June 1972 Year of Admission in the BSN Program : 2008 Year Graduated (BSN Program) : 2012
Year: NOT APPLICABLE
III. HANDLED DELIVERIES No.
Case No.
1
1231
2
1175
3
1161
Diagnosis
Name of Mother
Date of Delivery
Age Delivery term spontaneous an alive baby boy weighing 6.5 pounds with an APGAR score of 9. Gravida 1, Parity 1, Cephalic Presentation Delivery term spontaneous an alive baby boy weighing 5 pounds with an APGAR score of 9. Gravida 1, Parity 0, Cephalic Presentation Delivery term spontaneous an alive baby boy weighing 7.8 pounds with an APGAR score of 9. Gravida 3, Parity 3, Cephalic Presentation
Time of Delivery
Gender of Baby
Name of Hospital
Types of Delivery
Nurse/Midwife Name and Signature of Qualified DR On duty Clinical Instructor
Nucleus Medical Clinic and Birthing Home Nucleus Medical Clinic and Birthing Home Nucleus Medical Clinic and Birthing Home
Normal Spontaneous Vaginal Delivery Normal Spontaneous Vaginal Delivery Normal Spontaneous Vaginal Delivery
Lovel Catiil,RN
Mr. Andy Roy Salabas, Rn
Lovel Catiil,RN
Mrs. Elvyn Mabao, RN MN
Lovel Catiil,RN
Mrs. Elvyn Mabao, RN MN
Barbara Baculio
20
July 11, 2010
2:55 AM
Male
Tara Paula Joyce Amahan
19
June 13, 2010
1: 58 PM
Male
Jocelyn Lague
30
June 5, 2010
4: 51 AM
Male
Concurred by:
Prepared by:
PRC FORM TEMPLATE
Name and Signature of Student
Noted by:
VIVIAN L. CEBALLOS
RLE Chairperson /Clin. Coor. Liceo de Cagayan University Date Signed: ________________ Degree: BSN, RN, MAN PRC No: 0171698 Valid Until: September 7, 2011 PNA No: 17947 Valid Until: Lifetime Member
Concurred by:
Approved by:
MARIA CHONA V. PALOMARES Dean Liceo de Cagayan University Date Signed: _____________ Degree: B.S.N. RN M.A.N. PRC No.: 0080354 Valid Until: September 23, 2013 PNA No: 17266 Valid Until: Lifetime Member ADPCN No: _______________ Valid Until: December 31, 2011
LICEO DE CAGAYAN UNIVERSITY College of Nursing Rodolfo N. Pelaez Boulevard Kauswagan, Cagayan de Oro City
School Code: 0835
Name of Student: Name and Address of School: Recognition and Accreditation Level: Year Granted: Date when school was recognized:
ORONG, ALTHEA PAZ BALODO Liceo de Cagayan University – Rodolfo N. Pelaez Boulevard, Kauswagan, Cagayan de Oro City PACUCOA – Level III AUTONOMOUS First Course (if any): NOT APPLICABLE OCTOBER 2008 NOVEMBER 2009 School Graduated from: NOT APPLICABLE June 1972 Year of Admission in the BSN Program : 2008 Year Graduated (BSN Program) : 2012
Year: NOT APPLICABLE
IV. ASSISTED DELIVERIES No.
Case No.
1
1174
2
1217
3
650, 563
Diagnosis
Name of Mother
Delivery term spontaneous an alive baby boy weighing 7 pounds with an APGAR score of 9. Gravida 1, Parity 0, Cephalic Presentation Delivery term spontaneous an alive baby boy weighing 5.6 pounds with an APGAR score of 9. Gravida 2, Parity 2, Cephalic Presentation Delivery term spontaneous an alive baby girl weighing 3.4 kilograms with an APGAR score of 9. Gravida 1, Parity 1, Cephalic Presentation
PRC FORM TEMPLATE
Name and Signature of Student
Date of Delivery
Time of Delivery
Gender of Baby
Name of Hospital Nucleus Medical Clinic and Birthing Home Nucleus Medical Clinic and Birthing Home JR Borja Memorial Hospital
Goldie Mae Bustamante
20
June 13, 2010
11: 29 AM
Male
Stephanie Paclar
32
July 3, 2010
5:03 PM
Male
Stephanie Decipolo
23
July 24, 2010
11; 21 PM
Female
Noted by: Prepared by:
Age
VIVIAN L. CEBALLOS
RLE Chairperson /Clin. Coor. Liceo de Cagayan University Date Signed: ________________ Degree: BSN, RN, MAN PRC No: 0171698 Valid Until: September 7, 2011 PNA No: 17947 Valid Until: Lifetime Member
Concurred by:
Concurred by:
Concurred by:
Types of Delivery Normal Spontaneous Vaginal Delivery Normal Spontaneous Vaginal Delivery Normal Spontaneous Vaginal Delivery
Name and Signature of Qualified DR Clinical Instructor Mrs. Elvyn Mabao, RN MN
Mrs. Ester Sy, RN MN
Mrs. Florence Baluran, RN MN
Approved by:
MARIA CHONA V. PALOMARES Dean Liceo de Cagayan University Date Signed: ______________ Degree: B.S.N. RN M.A.N. PRC No.: 0080354 Valid Until: September 23, 2013 PNA No: 17266 Valid Until: Lifetime Member ADPCN No: ______________ Valid Until: December 31, 2011
LICEO DE CAGAYAN UNIVERSITY College of Nursing Rodolfo N. Pelaez Boulevard Kauswagan, Cagayan de Oro City
School Code: 0835
Name of Student: Name and Address of School: Recognition and Accreditation Level: Year Granted: Date when school was recognized: Number:
ORONG, ALTHEA PAZ BALODO Liceo de Cagayan University – Rodolfo N. Pelaez Boulevard, Kauswagan, Cagayan de Oro City PACUCOA – Level III First Course (if any): Not Applicable 2008 School Graduated from: June 1972 Year of Admission in the BSN Program: 2008 37 Year Graduated (BSN Program): 2012
Year:
V. IMMEDIATE NEWBORN CARE Case No.
Date Performed
Name of Baby
No.
Gender of Baby
Name of Mother
Age
1
1167
June 8, 2010
Baby Boy Martinez
Male
Mayette Martinez
20
2
1218
June 23, 2010
Baby Boy Dumaog
Male
Annaliza Dumaog
33
3
650, 473
July 25, 2010
Baby Boy Ebal
Male
WIlda Ebal
26
Nurse/Midwife On duty
Name of Hospital Nucleus Medical Clinic and Birthing Home Nucleus Medical Clinic and Birthing Home JR Borja Memorial Hospital
Name and Signature of Qualified DR Clinical Instructor
Lovel Catiil, RN
Mrs. Elvyn Mabao, RN MN
Lovel Catiil, RN
Mrs. Ester Sy, RN MN
Gemma Omonbos, RN
Mrs. Florence Baluran, RN MN
Approved by:
Prepared by:
ORONG, ALTHEA PAZ Name and Signature of Student
Noted by:
VIVIAN L. CEBALLOS
RLE Chairperson /Clin. Coor. Liceo de Cagayan University Date Signed: ________________ Degree: BSN, RN, MAN PRC No: 0171698 Valid Until: September 7, 2011 PNA No: 17947 Valid Until: Lifetime Member
Concurred by:
Concurred by:
Concurred by:
MARIA CHONA V. PALOMARES Dean Liceo de Cagayan University Date Signed: ______________ Degree: B.S.N. RN M.A.N. PRC No.: 0080354 Valid Until: September 23, 2013 PNA No: 17266 Valid Until: Lifetime Member ADPCN No: _______________ Valid Until: December 31, 2011
School Code: 0835
Name of Student: Name and Address of School: Recognition and Accreditation Level: Year Granted: Date when school was recognized:
ORONG, ALTHEA PAZ BALODO Liceo de Cagayan University – Rodolfo N. Pelaez Boulevard, Kauswagan, Cagayan de Oro City PACUCOA – Level III AUTONOMOUS First Course (if any): NOT APPLICABLE OCTOBER 2008 NOVEMBER 2009 School Graduated from: NOT APPLICABLE June 1972 Year of Admission in the BSN Program : 2008 Year Graduated (BSN Program) : 2012
Year: NOT APPLICABLE
I. MAJOR OPERATIONS No. 1
Date of Operation
Case No.
Name of Patient
Diagnosis
July 13, 2010
3785
Yasin, Anisah
Open Fracture Medial Third Tibia Fibula Right
September 27, 2010
763968
Ricky Llanto
2
Mandibular Fracture, depressed (right)
October 20, 2010
6085
Irene Tiu
3
Endometrial hyperplasia rule out Endometrial Carcinoma
Operation Performed
Types of Anesthesia
Name of Surgeon
Name of Hospital
Cagayan Polymedic General Hospital Northern Mindanao medial Center
Mrs. Maria Madel C. Reyes, RN
Cagayan Polymedic General Hospital
Jade Claire O. Alvarez, RN
Debridement Irrigation Open Reduction Inter-Medullary; Interlocking nail, right tibia Open Reduction Internal Fixation of depressed malar fracture using Titanium/ Orbityl plates; Open Reduction Internal Fixation of Mandiblar Fracture using Titanium plates; Mandibulomaxillary Fixation
Spinal anesthesia
Dr. Jovito Lao
General Anesthesia
Dr. Robert Gomez
Cervical punch biopsy, Fractional dilatation and curettage
Spinal Anesthesia
Dr. Jana Joy Tursalem
Name of Qualified OR Scrub Nurse
Fidelo Rey Mandawe, RN
Approved by: Prepared by:
NAME
Name and Signature of Student
Supervised by:
GINA S. BATASIN-IN
OR Clinical Instructor Liceo de Cagayan University Date Signed: _____________ Degree: BSN, RN,MN PRC No: 0157111 Valid Until: December 10, 2013 PNA No: Valid Until: October 31, 2011
Noted by:
VIVIAN L. CEBALLOS
RLE Chairperson /Clin. Coor. Liceo de Cagayan University Date Signed: ________________ Degree: BSN, RN, MAN PRC No: 0171698 Valid Until: September 7, 2014 PNA No: 17947 Valid Until: Lifetime Member
Concurred by: Concurred by:
MARIA CHONA V. PALOMARES Dean Liceo de Cagayan University Date Signed: _______________ Degree: B.S.N., M.A.N. PRC No.: 0080354 Valid Until: September 23, 2013 PNA No: 17266 Valid Until: Lifetime Member ADPCN No: ________________ Valid Until: December 31, 2011
Signature of Qualified OR Scrub Nurse
LICEO DE CAGAYAN UNIVERSITY College of Nursing Rodolfo N. Pelaez Boulevard Kauswagan, Cagayan de Oro City
School Code: 0835 Name of Student: Name and Address of School: Recognition and Accreditation Level: Year Granted: Date when school was recognized:
ORONG, ALTHEA PAZ BALODO Liceo de Cagayan University – Rodolfo N. Pelaez Boulevard, Kauswagan, Cagayan de Oro City PACUCOA – Level III AUTONOMOUS First Course (if any): NOT APPLICABLE OCTOBER 2008 NOVEMBER 2009 School Graduated from: NOT APPLICABLE June 1972 Year of Admission in the BSN Program : 2008 Year Graduated (BSN Program) : 2012
Year: NOT APPLICABLE
II. MAJOR OPERATIONS No.
Date of Operation
Case No.
Name of Patient
Operation Performed
Diagnosis
1
May 26, 2011
02679
Quilab, Glyza Shamil
Cleft lip complete
Cheiloplasty
2
December 10, 2010
210272 4
Hibaya, Vanessa Myla
3
July 5, 2010
001105
Lota Generalao
Preterm cephalic not in labor oligohydramnios delivered live baby boy with an APGAR score of 10, body weight of 10 Mature Cataract Left Eye
Low section cesarean section myomectomy Phaco emulsification of Cataract Left Eye
Types of Anesthesia
Name of Surgeon
Name of Hospital
Name of Qualified OR Circulatinhg Nurse
General Endotracheal Anesthesia Spinal Anesthesia
Dr. Veronica Abelera
Kriss Kringle Virtudes, RN
Dr. Reynaldo Chu
Cagayan Polymedic General Hospital Madonna and Child Hospital
Retrobulbar block
Dr. Carlo Antonio J. Romero
Cagayan Polymedic General Hospital
RC Ann Macaranas, RN
Signature of Qualified OR Scrub Nurse
Letecia Reyes, RN
Prepared by:
PRC FORM TEMPLATE
Name and Signature of Student
Supervised by:
GINA S. BATASIN-IN
OR Clinical Instructor Liceo de Cagayan University Date Signed: _____________ Degree: BSN, RN, MN PRC No: 0157111 Valid Until: December 10, 2013 PNA No: Valid Until: December 31, 2011
Noted by:
VIVIAN L. CEBALLOS
RLE Chairperson /Clin. Coor. Liceo de Cagayan University Date Signed: ___________ Degree: BSN, RN, MAN PRC No: 0171698 Valid Until: September 7, 2011 PNA No: 17947 Valid Until: Lifetime Member
Concurred by:
Concurred by:
Concurred by:
Approved by:
MARIA CHONA V. PALOMARES Dean Liceo de Cagayan University Date Signed: ______________ Degree: B.S.N. RN M.A.N. PRC No.: 0080354 Valid Until: September 23, 2013 PNA No: 17266 Valid Until: Lifetime Member ADPCN No: ________________ Valid Until: December 31, 2011
LICEO DE CAGAYAN UNIVERSITY College of Nursing Rodolfo N. Pelaez Boulevard Kauswagan , Cagayan de Oro City
School Code: 0835 Name of Student: Name and Address of School: Recognition and Accreditation Level: Year Granted: Date when school was recognized:
ORONG, ALTHEA PAZ BALODO Liceo de Cagayan University – Rodolfo N. Pelaez Boulevard, Kauswagan, Cagayan de Oro City PACUCOA – Level III AUTONOMOUS First Course (if any): NOT APPLICABLE OCTOBER 2008 NOVEMBER 2009 School Graduated from: NOT APPLICABLE June 1972 Year of Admission in the BSN Program : 2008 Year Graduated (BSN Program) : 2012
Year: NOT APPLICABLE
III. HANDLED DELIVERIES No.
Case No.
1
1231
2
1175
3
1161
Diagnosis
Name of Mother
Date of Delivery
Age Delivery term spontaneous an alive baby boy weighing 6.5 pounds with an APGAR score of 9. Gravida 1, Parity 1, Cephalic Presentation Delivery term spontaneous an alive baby boy weighing 5 pounds with an APGAR score of 9. Gravida 1, Parity 0, Cephalic Presentation Delivery term spontaneous an alive baby boy weighing 7.8 pounds with an APGAR score of 9. Gravida 3, Parity 3, Cephalic Presentation
Time of Delivery
Gender of Baby
Name of Hospital
Types of Delivery
Nurse/Midwife Name and Signature of Qualified DR On duty Clinical Instructor
Nucleus Medical Clinic and Birthing Home Nucleus Medical Clinic and Birthing Home Nucleus Medical Clinic and Birthing Home
Normal Spontaneous Vaginal Delivery Normal Spontaneous Vaginal Delivery Normal Spontaneous Vaginal Delivery
Lovel Catiil,RN
Mr. Andy Roy Salabas, Rn
Lovel Catiil,RN
Mrs. Elvyn Mabao, RN MN
Lovel Catiil,RN
Mrs. Elvyn Mabao, RN MN
Barbara Baculio
20
July 11, 2010
2:55 AM
Male
Tara Paula Joyce Amahan
19
June 13, 2010
1: 58 PM
Male
Jocelyn Lague
30
June 5, 2010
4: 51 AM
Male
Concurred by:
Prepared by:
PRC FORM TEMPLATE
Name and Signature of Student
Noted by:
VIVIAN L. CEBALLOS
RLE Chairperson /Clin. Coor. Liceo de Cagayan University Date Signed: ________________ Degree: BSN, RN, MAN PRC No: 0171698 Valid Until: September 7, 2011 PNA No: 17947 Valid Until: Lifetime Member
Concurred by:
Approved by:
MARIA CHONA V. PALOMARES Dean Liceo de Cagayan University Date Signed: _____________ Degree: B.S.N. RN M.A.N. PRC No.: 0080354 Valid Until: September 23, 2013 PNA No: 17266 Valid Until: Lifetime Member ADPCN No: _______________ Valid Until: December 31, 2011
LICEO DE CAGAYAN UNIVERSITY College of Nursing Rodolfo N. Pelaez Boulevard Kauswagan, Cagayan de Oro City
School Code: 0835
Name of Student: Name and Address of School: Recognition and Accreditation Level: Year Granted: Date when school was recognized:
ORONG, ALTHEA PAZ BALODO Liceo de Cagayan University – Rodolfo N. Pelaez Boulevard, Kauswagan, Cagayan de Oro City PACUCOA – Level III AUTONOMOUS First Course (if any): NOT APPLICABLE OCTOBER 2008 NOVEMBER 2009 School Graduated from: NOT APPLICABLE June 1972 Year of Admission in the BSN Program : 2008 Year Graduated (BSN Program) : 2012
Year: NOT APPLICABLE
IV. ASSISTED DELIVERIES No.
Case No.
1
1174
2
1217
3
650, 563
Diagnosis
Name of Mother
Delivery term spontaneous an alive baby boy weighing 7 pounds with an APGAR score of 9. Gravida 1, Parity 0, Cephalic Presentation Delivery term spontaneous an alive baby boy weighing 5.6 pounds with an APGAR score of 9. Gravida 2, Parity 2, Cephalic Presentation Delivery term spontaneous an alive baby girl weighing 3.4 kilograms with an APGAR score of 9. Gravida 1, Parity 1, Cephalic Presentation
PRC FORM TEMPLATE
Name and Signature of Student
Date of Delivery
Time of Delivery
Gender of Baby
Name of Hospital Nucleus Medical Clinic and Birthing Home Nucleus Medical Clinic and Birthing Home JR Borja Memorial Hospital
Goldie Mae Bustamante
20
June 13, 2010
11: 29 AM
Male
Stephanie Paclar
32
July 3, 2010
5:03 PM
Male
Stephanie Decipolo
23
July 24, 2010
11; 21 PM
Female
Noted by: Prepared by:
Age
VIVIAN L. CEBALLOS
RLE Chairperson /Clin. Coor. Liceo de Cagayan University Date Signed: ________________ Degree: BSN, RN, MAN PRC No: 0171698 Valid Until: September 7, 2011 PNA No: 17947 Valid Until: Lifetime Member
Concurred by:
Concurred by:
Concurred by:
Types of Delivery Normal Spontaneous Vaginal Delivery Normal Spontaneous Vaginal Delivery Normal Spontaneous Vaginal Delivery
Name and Signature of Qualified DR Clinical Instructor Mrs. Elvyn Mabao, RN MN
Mrs. Ester Sy, RN MN
Mrs. Florence Baluran, RN MN
Approved by:
MARIA CHONA V. PALOMARES Dean Liceo de Cagayan University Date Signed: ______________ Degree: B.S.N. RN M.A.N. PRC No.: 0080354 Valid Until: September 23, 2013 PNA No: 17266 Valid Until: Lifetime Member ADPCN No: ______________ Valid Until: December 31, 2011
LICEO DE CAGAYAN UNIVERSITY College of Nursing Rodolfo N. Pelaez Boulevard Kauswagan, Cagayan de Oro City
School Code: 0835
Name of Student: Name and Address of School: Recognition and Accreditation Level: Year Granted: Date when school was recognized: Number:
ORONG, ALTHEA PAZ BALODO Liceo de Cagayan University – Rodolfo N. Pelaez Boulevard, Kauswagan, Cagayan de Oro City PACUCOA – Level III First Course (if any): Not Applicable 2008 School Graduated from: June 1972 Year of Admission in the BSN Program: 2008 37 Year Graduated (BSN Program): 2012
Year:
V. IMMEDIATE NEWBORN CARE Case No.
Date Performed
Name of Baby
No.
Gender of Baby
Name of Mother
Age
1
1167
June 8, 2010
Baby Boy Martinez
Male
Mayette Martinez
20
2
1218
June 23, 2010
Baby Boy Dumaog
Male
Annaliza Dumaog
33
3
650, 473
July 25, 2010
Baby Boy Ebal
Male
WIlda Ebal
26
Nurse/Midwife On duty
Name of Hospital Nucleus Medical Clinic and Birthing Home Nucleus Medical Clinic and Birthing Home JR Borja Memorial Hospital
Name and Signature of Qualified DR Clinical Instructor
Lovel Catiil, RN
Mrs. Elvyn Mabao, RN MN
Lovel Catiil, RN
Mrs. Ester Sy, RN MN
Gemma Omonbos, RN
Mrs. Florence Baluran, RN MN
Approved by:
Prepared by:
ORONG, ALTHEA PAZ Name and Signature of Student
Noted by:
VIVIAN L. CEBALLOS
RLE Chairperson /Clin. Coor. Liceo de Cagayan University Date Signed: ________________ Degree: BSN, RN, MAN PRC No: 0171698 Valid Until: September 7, 2011 PNA No: 17947 Valid Until: Lifetime Member
Concurred by:
Concurred by:
Concurred by:
MARIA CHONA V. PALOMARES Dean Liceo de Cagayan University Date Signed: ______________ Degree: B.S.N. RN M.A.N. PRC No.: 0080354 Valid Until: September 23, 2013 PNA No: 17266 Valid Until: Lifetime Member ADPCN No: _______________ Valid Until: December 31, 2011
