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UNIVERSITY OF LA SALETTE
COLLEGE OF NURSING
Santiago City
Prepared By:
Name of Student: CARIAGA, CERELINA BALBUENA
Name & Address of School:UNIVERSITY OF LA SALETTE, Bachelor St., Dubinan East, Santiago City, Isabela, Philippines
Accreditation Level: (if any):PAASCU Accredited Level II Year Granted: 2002
Date School/Program was Recognized:January 24, 1996 Number:014
Year of Admission in the Bachelor of Nursing Program:2008
Year Graduated (BSN Program):2012
III. ACTUAL DELIVERIES
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:
Name and Signature of Qualified C.I
1.
005546
Pregnancy Uterine Full Term,
38 Weeks Age Of Gestation,
Cephalic In Presentation, In
Labor, Gravida2, Parity1
Jhonalyn Taracatac 24 August 30, 2010 12:43 PM Male
Echague District
Hospital
Normal Spontaneous
Delivery
Felicita M. Balico RN, MAN
2.
1097-89
Pregnancy Uterine Full Term,
39weeks Age Of Gestation,
Cephalic In Presentation, In
Labor, Gravida1, Parity0
Jessica Uao 17 February 2, 2012 5:00AM Male
Southern Isabela
General Hospital
Normal Spontaneous
Delivery
Melba M. Vizcarra, RN
3.
593
Pregnancy Uterine Full
Term,40 Weeks Age Of
Gestation, Cephalic In
Presentation, In Labor,
Gravida4, Parity2
Remalyn Bareng 38 February 23, 2012 8:40 AM Female
Alicia Rural Health
Unit
Normal Spontaneous
Delivery
Jamie P. Gabriel, RN
4.
1113-40
Pregnancy Uterine Full Term,
42 Weeks Age Of Gestation,
Cephalic In Presentation, In
Labor, Gravida1, Parity0
Florence Requiso 38 February 24, 2012 2:00 PM Female
Alicia Rural Health
Unit
Normal Spontaneous
Delivery
Jamie P. Gabriel, RN
5.
1122-95
Pregnancy Uterine Full Term,
39 Weeks Age Of Gestation,
Cephalic In Presentation, In
Labor, Gravida2, Parity1
Arjhay Sartagoda 31 March 11, 2012 3:45 PM Male
Southern Isabela
General Hospital
Normal Spontaneous
Delivery
Melba M. Vizcarra, RN
Supervised by:
MELBA M. VIZCARRA RN, MPH
Clinical Instructor
Southern Isabela General Hospital
Santiago City, Isabela
Date Signed: ____________________
CTC No. : 04663311
Date Issued: March 9, 2012
Place Issued: Santiago City, Isabela
PRC No.:0061522
Valid Until: September 14, 2012
PNA No.: 2012-023618
Valid Until: October 31, 2012
Concurred by:
EUGENIAPIERA RN, MAN
Chief Nurse
Southern Isabela General Hospital
Santiago City, Isabela
Date Signed: ____________________
CTC No.: 22701697
Date Issued: January 6, 2012
Placed Issued: Santiago City, Isabela
PRC No.: 0051279
Valid Until: September 6, 2014
PNA No.: 15240
Valid Until: Lifetime
Supervised by:
JAIME GABRIEL RN, MSN
Clinical Instructor
Rural Health Unit
San Mateo, Isabela
Date Signed: ____________________
CTC No.: 012422594
Date Issued: February 5, 2012
Place Issued: Santiago City, Isabela
PRC No.: 0320189
Valid Until: December 18, 2014
PNA No.: 2012-048935
Valid Until: October 31, 2012
Concurred by:
DIETELINDA DELA PEA, RN, DPN
Head Nurse
Rural Health Unit San Mateo
Brgy.4, San Mateo, Isabela
Date Signed: ___________________
PRC No.: 0084612
Valid Until: May 22, 2012
PNA No.: 2012-023585
Valid Until: October 31, 2012
CTC No.: 04550538
Date Issued: January 10, 2012
Place Issued: San Mateo, Isabela
Supervised by:
FELICITA B. BALICO, RN,MAN
Clinical Instructor
Echague District Hospital
Echague, Isabela
Date Signed:___________________
CTC No: 18389504
Date Issued: January 16, 2012
Place Issued: San Isidro, Isabela
a). PRC No. 0085028
Valid Until: September 2013
b). PNA No: 006766
Valid Until: January 2013
Concurred by:
JOSEPHINE D. FORONDA
Chief Nurse
Echague District Hospital
Echague, Isabela
Date Signed: _________________________
CTC No.:04518647
Date Issued: March 9, 2012
Placed Issued: Cauayan City, Isabela
PRC No.: 0115029
Valid Until: April 17, 2013
Noted by:
MARIA THERESAG. SANTOS RN, MSN
Clinical Coordinator, College of Nursing
University of La Salette
Santiago City, Isabela
Date Signed: __________________
CTC No.:04543860
Date Issued: February 21, 2012
Placed Issued: Alicia, Isabela
PRC No.: 0322506
Valid Until: September 20, 2013
PNA No.: 2012-023674
Valid Until: October 31, 2012
Approved by:
MAY C. TARUC, RN, MSN
Dean College of Nursing
University of La Salette
Santiago City, Isabela
Date Signed: ____
CTC No.: 04663323
Date Issued: March 12, 2012
Placed Issued: Ramon, Isabela
PRC No.: 09192369
Valid Until: May 12, 2014
PNA No.: 2012-023552
Valid Until: October 31, 2012
ADCPN No: 11-039
Valid Until: December 2014
Valid Until: December 2014
REPUBLIC OF THE PHILIPPINES
UNIVERSITY OF LA SALETTE
COLLEGE OF NURSING
Santiago City
Prepared By:
Name of Student: CARIAGA, CERELINA BALBUENA
Name & Address of School:UNIVERSITY OF LA SALETTE, Bachelor St., Dubinan East, Santiago City, Isabela, Philippines
Accreditation Level: (if any):PAASCU Accredited Level II Year Granted: 2002
Date School/Program was Recognized:January 24, 1996 Number:014
Year of Admission in the Bachelor of Nursing Program:2008
Year Graduated (BSN Program):2012
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:
Name and Signature of Qualified C.I
1.
1093-51
Pregnancy Uterine Full Term, 38
Weeks Age Of Gestation, Cephalic
In Presentation, In Labor, Gravida3,
Parity2
Rosalyn Regindin 34 January 26, 2012 11:40 PM Male
Southern Isabela General
Hospital
Normal Spontaneous Delivery Melba M. Vizcarra, RN
2.
1107-08
Pregnancy Uterine Full Term, 39
Weeks Age Of Gestation, Cephalic
In Presentation, In Labor, Gravida2,
Parity1
Amelia Bad-ang 38 February 16, 2012 5:25 AM Female
Southern Isabela General
Hospital
Normal Spontaneous Delivery Melba M. Vizcarra, RN
3.
594
Pregnancy Uterine Full Term, 38
Weeks Age Of Gestation, Cephalic
In Presentation, In Labor, Gravida3,
Parity2
Nida Tamap 31 February 23, 2012 3:45 PM Female Alicia Rural Health Unit Normal Spontaneous Delivery Jamie P. Gabriel, RN
4.
1116-24
Pregnancy Uterine Full Term, 38
Weeks Age Of Gestation, Cephalic
In Presentation, In Labor, Gravida2,
Parity1
Jenny Garis 22 February 29, 2012 10:19 PM Female
Southern Isabela General
Hospital
Normal Spontaneous Delivery Melba M. Vizcarra, RN
5.
1146-26
Pregnancy Uterine Full Term, 36
Weeks Age Of Gestation, Transverse
In Presentation, In Labor, Gravida4,
Parity3
Fovie Lawayan 42 February 27, 2012 6:30 AM Male
Southern Isabela General
Hospital
Normal Spontaneous Delivery Melba M. Vizcarra, RN
Supervised by:
JAIME GABRIEL RN, MSN
Clinical Instructor
Rural Health Unit
San Mateo, Isabela
Date Signed: ____________________
CTC No.: 012422594
Date Issued: February 5, 2012
Place Issued: Santiago City, Isabela
PRC No.: 0320189
Valid Until: December 18, 2014
PNA No.: 2012-048935
Valid Until: October 31, 2012
Concurred by:
DIETELINDA DELA PEA, RN,
DPN
Head Nurse
Rural Health Unit San Mateo
Brgy.4, San Mateo, Isabela
Date Signed: ___________________
PRC No.: 0084612
Valid Until: May 22, 2012
PNA No.: 2012-023585
Valid Until: October 31, 2012
CTC No.: 04550538
Date Issued: January 10, 2012
Place Issued: San Mateo, Isabela
Concurred by:
EUGENIA PIERA RN, MAN
Chief Nurse
Southern Isabela General Hospital
Santiago City, Isabela
Date Signed: ____________________
CTC No.: 22701697
Date Issued: January 6, 2012
Placed Issued: Santiago City, Isabela
PRC No.: 0051279
Valid Until: September 6, 2014
PNA No.: 15240
Valid Until: Lifetime
Noted by:
JOSEPHINE D. FORONDA
Chief Nurse
Echague District Hospital
Echague, Isabela
Date Signed:
_________________________
CTC No.:04518647
Date Issued: March 9, 2012
Placed Issued: Cauayan City, Isabela
PRC No.: 0115029
Valid Until: April 17, 2013
Noted by:
MARIA THERESA G. SANTOS RN, MSN
Clinical Coordinator, College of Nursing
University of La Salette
Santiago City,Isabela
Date Signed:
_________________________
CTC No.:04543860
Date Issued: February 21, 2012
Placed Issued: Alicia, Isabela
PRC No.: 0322506
Valid Until: September 20, 2013
PNA No.: 2012-023674
Valid Until: October 31, 2012
Approved by:
MAY C. TARUC, RN, MSN
Dean College of Nursing
University of La Salette
Santiago City, Isabela
Date Signed: ____
CTC No.: 04663323
Date Issued: March 12, 2012
Placed Issued: Ramon, Isabela
PRC No.: 09192369
Valid Until: May 12, 2014
PNA No.: 2012-023552
Valid Until: October 31, 2011
ADCPN No: 11-039
Valid Until: December 2014
REPUBLIC OF THE PHILIPPINES
UNIVERSITY OF LA SALETTE
COLLEGE OF NURSING
Santiago City
Prepared By:
Name of Student: CARIAGA, CERELINA BALBUENA
Name & Address of School: UNIVERSITY OF LA SALETTE, Bachelor St., Dubinan East, Santiago City, Isabela, Philippines
Accreditation Level: (if any): PAASCU Accredited Level II Year Granted: 2002
Date School/Program was Recognized: January 24, 1996 Number: 014
Year of Admission in the Bachelor of Nursing Program: 2008
Year Graduated (BSN Program):2012
V. CORD DRESSING
No.
Case
No.
Date of Delivery
Name of Baby
Gender of Baby
Name of Mother
Age
Name of Hospital
Type of Delivery
Supervised by:
Name and Signature of Qualified C.I
1.
1101-82
February 7, 2012
Bb. Girl Tomita
Female
Mareline Tomita
27
Southern Isabela General Hospital
Normal Spontaneous Delivery
Melba M. Vizcarra, RN
2.
1103-47
February 10, 2012
Bb. Girl Agustin
Female
Shirley Agustin
26
Southern Isabela General Hospital
Normal Spontaneous Delivery
Melba M. Vizcarra, RN
3.
1104-10 February 11, 2012 Bb. Girl Bareng Female Remalyn Bareng 24
Southern Isabela General Hospital
Normal Spontaneous Delivery
Melba M. Vizcarra, RN
4.
595
February 24, 2012
Bb. Boy Valdez
Male
Mary Joy Valdez
21
Alicia Rural Health Unit Normal Spontaneous Delivery Jamie P. Gabriel, RN
5.
604
March 1, 2012
Bb. Boy Galayan
Male
Lorena Galayan
24 Alicia Rural Health Unit Normal Spontaneous Delivery Jamie P. Gabriel, RN
Supervised by:
MELBA M. VIZCARRA RN, MPH
Clinical Instructor
Southern Isabela General Hospital
Santiago City, Isabela
Date Signed: ____________________
CTC No. : 04663311
Date Issued: March 9, 2012
Place Issued: Santiago City, Isabela
PRC No.:0061522
Valid Until: September 14, 2012
PNA No.: 2012-023618
Valid Until: October 31, 2012
Concurred by:
EUGENIA PIERA RN, MAN
Chief Nurse
Southern Isabela General Hospital
Santiago City, Isabela
Date Signed: ____________________
CTC No.: 22701697
Date Issued: January 6, 2012
Placed Issued: Santiago City, Isabela
PRC No.: 0051279
Valid Until: September 6, 2014
PNA No.: 15240
Valid Until: Lifetime
Supervised by:
JAIME GABRIEL RN, MSN
Clinical Instructor
Rural Health Unit
San Mateo, Isabela
Date Signed: ____________________
CTC No.: 012422594
Date Issued: February 5, 2012
Place Issued: Santiago City, Isabela
PRC No.: 0320189
Valid Until: December 18, 2014
PNA No.: 2012-048935
Valid Until: October 31, 2012
Concurred by:
DIETELINDA DELA PEA, RN, DPN
Head Nurse
Rural Health Unit San Mateo
Brgy.4, San Mateo, Isabela
Date Signed: ___________________
PRC No.: 0084612
Valid Until: May 22, 2012
PNA No.: 2012-023585
Valid Until: October 31, 2012
CTC No.: 04550538
Date Issued: January 10, 2012
Place Issued: San Mateo, Isabela
Noted by:
MARIA THERESA G. SANTOS RN, MSN
Clinical Coordinator, College of Nursing
University of La Salette
Santiago City,Isabela
Date Signed:
_________________________
CTC No.:04543860
Date Issued: February 21, 2012
Placed Issued: Alicia, Isabela
PRC No.: 0322506
Valid Until: September 20, 2013
PNA No.: 2012-023674
Valid Until: October 31, 2012
Approved by:
MAY C. TARUC, RN, MSN
Dean College of Nursing
University of La Salette
Santiago City, Isabela
Date Signed: ____
CTC No.: 04663323
Date Issued: March 12, 2012
Placed Issued: Ramon, Isabela
PRC No.: 09192369
Valid Until: May 12, 2014
PNA No.: 2012-023552
Valid Until: October 31, 2011
ADCPN No: 11-039
Valid Until: December 2014
\
REPUBLIC OF THE PHILIPPINES
UNIVERSITY OF LA SALETTE
COLLEGE OF NURSING
Santiago City
Prepared By:
Name of Student: BAYUBAY, MERRILL HANS SORIANO
Name & Address of School:UNIVERSITY OF LA SALETTE, Bachelor St., Dubinan East, Santiago City, Isabela, Philippines
Accreditation Level: (if any):PAASCU Accredited Level II Year Granted: 2002
Date School/Program was Recognized:January 24, 1996 Number: 014
Year of Admission in the Bachelor of Nursing Program:2008
Year Graduated (BSN Program):2012
II. MINOR OPERATIONS
No. Case No. Date of Operation Name of Patient Diagnosis Operation
Performed
Type of
Anesthesia
Name of Surgeon Name of
Hospital
Name of OR/Scrub
Nurse
Signature of
OR/Scrub Nurse
1.
011614
June 22, 2010
Jeoffrey Marinay
Multiple Laceratio at the Right Foot
Wound Suturing
Local anesthesia
Honorario Caramancion,
MD
Echague District
Hospital
Felicita B.Balico, RN
2.
1083-21
January 15, 2012
OJ Ezikiel Olivar
Burn Secondary, Third Lateral
Aspect Left Foot
Repeat Debridement
Intravenous Sedation
German Mabbayad, MD
Southern Isabela General
Hospital
Marion Capili, RN
3.
1108-64
February 18, 2012
Lilibeth Razonables
Intrauterine Fetal Demish
Dilatation and Curettage
Intravenous Sedation
Roselyn Dadural, MD
Southern Isabela General
Hospital
Rose Mendoza, RN
4.
1078-23
February 27, 2012
Evelyn Palen
Multiparity, Gravida3, Parity3
Bilateral Tubal Ligation
Subarachnoid Block
Roselyn Dadural, MD
Southern Isabela General
Hospital
Rose Mendoza, RN
5.
1124-31
March 13, 2012
Mimilin Tandas
H. Mole Rule Out Missed Abortion
Dilatation and Curettage
Subarachnoid Block
Roselyn Dadural, MD
Southern Isabela General
Hospital
Rose Mendoza, RN
Supervised by:
MELBA M. VIZCARRA RN, MPH
Clinical Instructor
Southern Isabela General Hospital
Santiago City, Isabela
Date Signed: ____________________
CTC No. : 04663311
Date Issued: March 9, 2012
Place Issued: Santiago City, Isabela
PRC No.:0061522
Valid Until: September 14, 2012
PNA No.: 2012-023618
Valid Until: October 31, 2012
Concurred by:
EUGENIA PIERA RN, MAN
Chief Nurse
Southern Isabela General Hospital
Santiago City, Isabela
Date Signed: ____________________
CTC No.: 22701697
Date Issued: January 6, 2012
Placed Issued: Santiago City, Isabela
PRC No.: 0051297
Valid Until: September 6, 2014
PNA No.: 15240
Valid Until: Lifetime
Supervised by:
FELICITA B. BALICO, RN,MAN
Clinical Instructor
Echague District Hospital
Echague, Isabela
Date Signed:___________________
CTC No
Date Issued
Place Issued
a). PRC No.
Valid Until
b). PNA No.
Valid Until
: 18389504
: January 16, 2012
: San Isidro, Isabela
: 0085028
: September 2013
: 006766
:January 2013
Concurred by:
JOSEPHINE D. FORONDA
Chief Nurse
Echague District Hospital
Echague, Isabela
Date Signed:
__________________
_______
CTC No.:04518647
Date Issued: March 9, 2012
Placed Issued: Cauayan City,
Isabela
PRC No.: 0115029
Valid Until: April 17, 2013
Noted by:
MARIA THERESA G. SANTOS RN, MSN
Clinical Coordinator, College of Nursing
University of La Salette
Santiago City,Isabela
Date Signed:
_________________________
CTC No.:04543860
Date Issued: February 21, 2012
Placed Issued: Alicia, Isabela
PRC No.: 0322506
Valid Until: September 20, 2013
PNA No.: 2012-023674
Valid Until: October 31, 2012
Approved by:
MAY C. TARUC, RN, MSN
Dean College of Nursing
University of La Salette
Santiago City, Isabela
Date Signed: ____
CTC No.: 04663323
Date Issued: March 12, 2012
Placed Issued: Ramon, Isabela
PRC No.: 09192369
Valid Until: May 12, 2014
PNA No.: 2012-023552
Valid Until: October 31, 2012
ADCPN No: 11-039
Valid Until: December 2014