(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: DUREZA,DEBBIE MARIEL LIRA________________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: _________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995_____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ____________
Year Admission in the Bachelor of Science in Nursing Program: June 2005____________________________________________________________
Year Graduated (BSN Program): October 14, 2009___________________________________________________________________________________

I. MAJOR OPERATION
Name of
Date of Case Operation Type of Name of Supervised by:
No. Name of Patient Diagnosis Name of Hospital O.R. Scrub
Operation No. Performed Anesthesia Surgeon Name of Faculty
Nurse
5 June 011131 Yanzon,Rocky Infected,fracture, Repeat GENERAL Michelle Corazon Locsin Bryan
15,2009 92 open type III-A, Debridemen Madalogdog Montelibano Pablo Jolo,Joemarie, RN
Date Signed______
complete t Memorial
Degree: RN
transverse distal Re- Regional PRC No:0263127
third radius, application Hospital Valid Until:June 4,
right;Status post of pins 2012
PNA No:021544
debridement radius,Right Valid Until:October
31,2010

Prepared by: Noted by: Concurred by: Approved by:

DEBBIE MARIEL L. DUREZA WILSIE A. BELECINA, RN, MN JORESLYN P. BALA-AN, RN, MN, Ma.ed HELEN V. CORREA, RN, MN,
Ed.D.
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of the Dean
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN, MN, Ma.ed Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0091019 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: May 24, 2011 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 03879 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: Lifeline Member Valid Until: October 31, 2010
 (FORMERLY WEST NEGROS COLLEGE)
COLLEGE OF NURSING
Bacolod City

Name of Student: DUREZA,DEBBIE MARIEL LIRA________________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: _________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995_____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ____________
Year Admission in the Bachelor of Science in Nursing Program: June 2005____________________________________________________________
Year Graduated (BSN Program): October 14, 2009___________________________________________________________________________________

I. MAJOR OPERATION
Type of
Date of Case Operation Name of Name of Name of O.R. Supervised by:
No. Name of Patient Diagnosis Anesthes
Operation No. Performed Surgeon Hospital Scrub Nurse Name of Faculty
ia
1 August 010690 Barbasa, Leslie Gravida 2 Para Repeat Low SPINA Mae Irene Corazon Locsin
25,2008 97 Ann 2(2002)pregnancy Transverse L Rife Montelibano Jaime
uterine full term caesarian Memorial Sibug,RN Belle C. Paparon,
cephalic;cephalo section(2x)with Regional RN,MN
pelvic Bilateral Tubal Hospital Date Signed______
Degree:RN,MN
disproportion Ligation(Modifi PRC No:0086493
ed Pomeroy) Valid Until:August
2 August 010691 Alimon,Fricy Gravida 2 Para 1 Primary Low 22,2010
25,2008 97 (1011)pregnancy Transverse PNA No:10553
Valid Until:Lifetime
uterine full Caesarian member
term,frank breech section

Prepared by: Noted by: Concurred by: Approved by:

DEBBIE MARIEL L. DUREZA WILSIE A. BELECINA, RN, MN JORESLYN P. BALA-AN, RN, MN, Ma.ed HELEN V. CORREA, RN,
MN, Ed.D.
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of the Dean
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN, MN, Ma.ed Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0091019 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: May 24, 2011 Valid Until: November 15, 2011
 b) PNA No. 045487 b) PNA No. 03879 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: Lifeline Member Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: DUREZA,DEBBIE MARIEL LIRA________________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: _________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995_____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ____________
Year Admission in the Bachelor of Science in Nursing Program: June 2005____________________________________________________________
Year Graduated (BSN Program): October 14, 2009___________________________________________________________________________________

I. MAJOR OPERATION
Supervised by:
Date of Case Operation Type of Name of O.R.
No. Name of Patient Diagnosis Name of Surgeon Name of Hospital Name of
Operation No. Performed Anesthesia Scrub Nurse
Faculty
3 Decembe 126766 Sy, Sybil kristine Acute Appendecto Spinal Sebastian
r 19,2008 Supperative my Tabuga The Doctors’ Dario Lausa
Clavano,Maricon ,
Appendicitis Hospital RN, MN
Incorporated Date Signed______
Degree: RN, MN
PRC No: 0080619
Valid Until: May 3,
2011
PNA No: 11009
Valid Until:
Lifetime Member

Prepared by: Noted by: Concurred by: Approved by:

DEBBIE MARIEL L. DUREZA WILSIE A. BELECINA, RN, MN EDITHA L. BAYONETA, RN, MN HELEN V. CORREA, RN, MN,
Ed.D.
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of the Dean
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN, MN Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0125661 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: August 8 2012 Valid Until: November 15, 2011
 b) PNA No. 045487 b) PNA No. 19677 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: Lifetime Member Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: DUREZA,DEBBIE MARIEL LIRA________________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: _________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995_____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ____________
Year Admission in the Bachelor of Science in Nursing Program: June 2005____________________________________________________________
Year Graduated (BSN Program): October 2009___________________________________________________________________________________

I. MAJOR OPERATION
Date of Type of Name of
Case Name of Operation Name of Name of Supervised by:
No. Operatio Diagnosis Anesthesi O.R. Scrub
No. Patient Performed Surgeon Hospital Name of Faculty
n a Nurse
Craniotomy 1st
Debridement Rex Araniador
Open Depressed and Elevation Date Signed______
Degree:RN
Comminuted skull fx of open Edgar
May Bacalian, Western Visayas PRC No:0203953
4 170170 Acolentava, Leo with brain comminuted General Lamprea,R Valid Until: January
12,2009 Steven Medical Center
Evisceration Right depressed skull N 26,2010
PNA No:030898
Parietal Area. fx. Right Valid Until: December 21,
parietal area 2009
Dueraraphy

Prepared by: Noted by: Concurred by: Approved by:

DEBBIE MARIEL L. DUREZA WILSIE A. BELECINA, RN, MN FREIDA G. SORONGON, RN,MAN HELEN V. CORREA, RN, MN,
Ed.D.
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of the Dean
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN, MAN Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0028836 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: August 16, 2011 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 17428 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: Lifetime Member Valid Until: October 31, 2010
 (FORMERLY WEST NEGROS COLLEGE)
COLLEGE OF NURSING
Bacolod City

Name of Student: DUREZA,DEBBIE MARIEL LIRA________________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: _________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995_____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ____________
Year Admission in the Bachelor of Science in Nursing Program: June 2005____________________________________________________________
Year Graduated (BSN Program): October 14, 2009___________________________________________________________________________________

II. MINOR OPERATION

Date of Type of
No Case Operation Name of Name of O.R. Supervised by: Name
Operatio Name of Patient Diagnosis Anesthesi Name of Hospital
. No. Performed Surgeon Scrub Nurse of Faculty
n a

3 110 Cardinas, Joshua Uncircumcised Circumcisio Local

Donna P. Javelona, RN
May 22, 9 Penis n Daniel T. Paez Dr. Jose C. Locsin Arlene G. Chu, Date Signed:
2009 Memorial RN Degree: RN
Maternity PRC No.: 0263971
4 112 Cordero, Ryan Uncircumcised Circumcisio Local Valid Until: February 8, 2013
8 Rey Penis n Clinic PNA No.: 045622
Valid Until: October 31,
2010

Prepared by: Noted by: Concurred by: Approved by:

DEBBIE MARIEL L. DUREZA WILSIE A. BELECINA, RN, MN ARLENE G. CHU, RN HELEN V. CORREA, RN, MN,
Ed.D.
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Public Health Nurse III Signature Over Printed Name of the
Dean
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0088075 a) PRC No. 56974
 Valid Until: February 8, 2012 Valid Until: February 6, 2011 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 044403 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: October 31, 2010 Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: DUREZA,DEBBIE MARIEL LIRA________________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: _________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995_____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ____________
Year Admission in the Bachelor of Science in Nursing Program: June 2005____________________________________________________________
Year Graduated (BSN Program): October 14, 2009___________________________________________________________________________________

II. MINOR OPERATION

Date of Type of
No Case Operation Name of Name of O.R. Supervised by: Name
Operatio Name of Patient Diagnosis Anesthesi Name of Hospital
. No. Performed Surgeon Scrub Nurse of Faculty
n a

1 April 25, 001451 Legarda, Wilson Incised Wound, Suturing, Local Mahal Gauze Janet M. Paez
Beverly Legada, RN, MN
2008 4 Index Finger, Right wound, Teresita L. Date Signed:
Hand Index Jalandoni Degree: RN, MN
Finger, Provincial Hospital PRC No.: 0126093
Valid Until: October 4, 2010
Hand, Right PNA No.: 044830
Valid Until: October 31,
2010

Prepared by: Noted by: Concurred by: Approved by:

DEBBIE MARIEL L. DUREZA WILSIE A. BELECINA, RN, MN MA. TERESA O. SEVERINO, RN, MN HELEN V. CORREA, RN,
MN, Ed.D.
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of the Dean
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN, MN Degree: RN, MN, Ed. D.
 a) PRC No. 0239072 a) PRC No. 0101938 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: April 27, 2011 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 174418 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: Lifetime Member Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: DUREZA,DEBBIE MARIEL LIRA________________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: _________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995_____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ____________
Year Admission in the Bachelor of Science in Nursing Program: June 2005____________________________________________________________
Year Graduated (BSN Program): October 14, 2009_________________________________________________________________________________

III. ACTUAL DELIVERIES

Gende
No Case Name of Date of Time of Name of Supervised by: Name of Qualified
Diagnosis Age r of Type of Delivery
. No. Mother Delivery Delivery Hospital C.I.
Baby

5 00-28- Pregnancy Panta, 32 July 6, 2009 3:18 AM Femal Well Family Normal Donna P. Javelona, RN
39 Uterine Full Term, Hedilita e Midwife Clinic Spontaneous Date Signed:
Gravida 4 Para 4 Vaginal Delivery Degree: RN
PRC No.: 0263971
Valid Until: February 8, 2013
PNA No.: 045622
Valid Until: October 31, 2010

Prepared by: Noted by: Concurred by: Approved by:

DEBBIE MARIEL L. DUREZA WILSIE A. BELECINA, RN, MN EDITH M. MONTIBOR, RM HELEN V. CORREA, RN,
MN, Ed.D.
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Clinic Manager Signature Over Printed Name of the
Dean
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RM Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0084399 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: November 12, 2012 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: DUREZA,DEBBIE MARIEL LIRA________________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: _________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995_____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ____________
Year Admission in the Bachelor of Science in Nursing Program: June 2005____________________________________________________________
Year Graduated (BSN Program): October 14, 2009_________________________________________________________________________________

IV. ASSISTED DELIVERIES

No Case Date of Time of Gender Supervised by: Name of
Diagnosis Name of Patient Age Name of Hospital Type of Delivery
. No. Delivery Delivery of Baby Qualified C.I.
1 011174 Pregnancy Uterine Piamonte, Aireen 21 June 18, 12:34 Female Corazon Locsin Normal
94 Full Term, Gravida 3 2009 AM Montelibano Memorial Spontaneous
Para 3 Regional Hospital Vaginal Delivery
Maricar S. Begasa, RN,MN
Date Signed:
2 011175 Pregnancy Uterine Sangasin, 23 June 18, 4:45 AM Female Normal Degree: RN,MN
PRC No.: 0317625
41 Full Term, Gravida 2 Michelle 2009 Spontaneous Valid Until: January 5, 2011
Para 2 Vaginal Delivery PNA No.: 044522
Valid Until: October 31, 2010

3 011175 Pregnancy Uterine Espinosa, Hannah 22 June 18, 5:43 AM Female Normal
42 Full Term, Gravida 1 Marie 2009 Spontaneous
Para 1 Vaginal Delivery

Prepared by: Noted by: Concurred by: Approved by:

DEBBIE MARIEL L. DUREZA WILSIE A. BELECINA, RN, MN JORESLYN P. BALA-AN, RN, MN, Ma.ed HELEN V. CORREA, RN,
MN, Ed.D.
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of the Dean
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN, MN, Ma.ed Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0091019 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: May 24, 2011 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 03879 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: Lifeline Member Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: DUREZA,DEBBIE MARIEL LIRA________________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: _________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995_____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ____________
Year Admission in the Bachelor of Science in Nursing Program: June 2005____________________________________________________________
Year Graduated (BSN Program): October 14, 2009_________________________________________________________________________________

IV. ASSISTED DELIVERIES

No Case Date of Time of Gender Supervised by: Name of
Diagnosis Name of Patient Age Name of Hospital Type of Delivery
. No. Delivery Delivery of Baby Qualified C.I.
4 011191 Pregnancy Uterine Sembran, Mary 20 June 27, 7:38 PM Male Corazon Locsin Normal
48 Full Term, Gravida 1 Jean 2009 Montelibano Memorial Spontaneous Moly V. Calamay, RN
Para 1 Regional Hospital Vaginal Delivery Date Signed:
Degree: RN
PRC No.: 0262640
Valid Until: November 6, 2012
5 011191 Pregnancy Uterine Javier, Anadhem 15 June 27, 8:32 PM Male Normal PNA No.: 044699
80 Full Term, Gravida 1 2009 Spontaneous Valid Until: October 31,2010
Para 1 Vaginal Delivery

Prepared by: Noted by: Concurred by: Approved by:

DEBBIE MARIEL L. DUREZA WILSIE A. BELECINA, RN, MN JORESLYN P. BALA-AN, RN, MN, Ma.ed HELEN V. CORREA, RN,
MN, Ed.D.
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of the Dean
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN, MN, Ma.ed Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0091019 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: May 24, 2011 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 03879 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: Lifeline Member Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: DUREZA,DEBBIE MARIEL LIRA________________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: _________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995_____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ____________
Year Admission in the Bachelor of Science in Nursing Program: June 2005____________________________________________________________
Year Graduated (BSN Program): October 14, 2009___________________________________________________________________________________

V. CORD DRESSING
Date Gender of Supervised by: Name of
No. Case No. Name of Baby Name of Mother Age Name of Hospital
Performed Baby Qualified C.I.

3 00-09-32 January 1 , Lambayong, kristina female Anna Lambayong 24

Peter John C. Dela Cruz,
2009 RMT,RN,MAN
Well Family Midwife Date Signed______
Clinic Degree: RMT,RN,MAN
PRC No:0362275
4 00-09-43 February Duermi, Rosalie female Kathrina Duermi 19 Valid Until; March 28, 2011
10,2009 PNA No:045621
Valid Until: Oct 31, 2010

Prepared by: Noted by: Concurred by: Approved by:

DEBBIE MARIEL L. DUREZA WILSIE A. BELECINA, RN, MN DOLORES P. PEDROSO, MN HELEN V. CORREA, RN,
MN, Ed.D.
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Clinic Manager Signature Over Printed Name of the
Dean
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: MN Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0057738 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: May 26, 2012 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 045219
Valid Until: October 21, 2010 Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: DUREZA,DEBBIE MARIEL LIRA________________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: _________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995_____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ____________
Year Admission in the Bachelor of Science in Nursing Program: June 2005____________________________________________________________
Year Graduated (BSN Program): October 14, 2009___________________________________________________________________________________

V. CORD DRESSING
Date Gender of Supervised by: Name of Qualified
No. Case No. Name of Baby Name of Mother Age Name of Hospital
Performed Baby C.I.

5 00-28-31 June 30, 2009 Caratao, Baby Girl Female Caratao, Dolores 2 Well Family Midwife Donna P. Javelona, RN
1 Clinic Date Signed:
Degree: RN
PRC No.: 0263971
Valid Until: February 8, 2013
PNA No.: 045622
Valid Until: October 31, 2010

Prepared by: Noted by: Concurred by: Approved by:

DEBBIE MARIEL L. DUREZA WILSIE A. BELECINA, RN, MN EDITH M. MONTIBOR, RM HELEN V. CORREA, RN,
MN, Ed.D.
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Clinic Manager Signature Over Printed Name of the
Dean
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RM Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0084399 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: November 12, 2012 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: DUREZA,DEBBIE MARIEL LIRA________________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: _________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995_____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ____________
Year Admission in the Bachelor of Science in Nursing Program: June 2005____________________________________________________________
Year Graduated (BSN Program): October 14, 2009___________________________________________________________________________________

V. CORD DRESSING
Date Gender of Supervised by: Name of
No. Case No. Name of Baby Name of Mother Age Name of Hospital
Performed Baby Qualified C.I.

1 09000919 January 31 , Arricivita, Baby Boy Male Arricivita,Elengie 33 Ignacio Lacson Arroyo Sr.
Joemarie M. Jolo, RN
2009 Memorial District Hospital Date Signed:
Degree: RN
PRC No.: 0263127
Valid Until: June 4, 2012
PNA No.: 021544
Valid Until: October 31, 2010

Prepared by: Noted by: Concurred by: Approved by:

DEBBIE MARIEL L. DUREZA WILSIE A. BELECINA, RN, MN ROSE MARY P. GAYARES, RN HELEN V. CORREA, RN, MN,
Ed.D.
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of the Dean
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0034577 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: December 25, 2011 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 021546 b) PNA No. 045219
Valid Until: October31, 2010 Valid Until: October 31. 2010 Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: DUREZA,DEBBIE MARIEL LIRA________________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: _________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995_____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ____________
Year Admission in the Bachelor of Science in Nursing Program: June 2005____________________________________________________________
Year Graduated (BSN Program): October 14, 2009_________________________________________________________________________________

III. ACTUAL DELIVERIES

Gende Supervised by: Name of
No Name of Date of Time of Name of
Case No. Diagnosis Age r of Type of Delivery Qualified
. Mother Delivery Delivery Hospital
Baby C.I.
2 01112737 Pregnancy Yayola, Jolyn 23 May 18, 8:39PM Male Corazon Locsin Normal
Uterine Full 2009 Montelibano Spontaneous
Term, Gravida Memorial Vaginal Delivery Moly V. Calamay, RN
Date Signed:
1 Para 1 Regional
Degree: RN
Hospital PRC No.: 0262640
Valid Until: November 6, 2012
PNA No.: 044699
Valid Until: October 31,2010
Prepared by: Noted by: Concurred by: Approved by:

DEBBIE MARIEL L. DUREZA WILSIE A. BELECINA, RN, MN JORESLYN P. BALA-AN, RN, MN, Ma.ed HELEN V. CORREA, RN,
MN, Ed.D.
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of the Dean
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN, MN, Ma.ed Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0091019 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: May 24, 2011 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 03879 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: Lifeline Member Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: DUREZA,DEBBIE MARIEL LIRA________________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: _________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995_____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ____________
Year Admission in the Bachelor of Science in Nursing Program: June 2005____________________________________________________________
Year Graduated (BSN Program): October 14, 2009_________________________________________________________________________________

III. ACTUAL DELIVERIES

Gende
No Case Name of Date of Time of Supervised by: Name of Qualified
Diagnosis Age r of Name of Hospital Type of Delivery
. No. Mother Delivery Delivery C.I.
Baby
Pregnancy Chavez, 18 June 28, 8:33PM Femal Normal Spontaneous
3 011193 Uterine Full Term, Stacylyn 2009 e Vaginal Delivery
87 Gravida 1 Para 1 Maricar S. Begasa, RN,MN
Corazon Locsin Date Signed:
Montelibano Degree: RN,MN
Pregnancy Ramirez, Ara 19 9:34PM Femal Memorial Normal Spontaneous PRC No.: 0317625
4 011194 Uterine Full Term, June 28, e Vaginal Delivery Valid Until: January 5, 2011
Regional PNA No.: 044522
05 Gravida 2 Para 2 2009 Hospital Valid Until: October 31, 2010
Prepared by: Noted by: Concurred by: Approved by:

DEBBIE MARIEL L. DUREZA WILSIE A. BELECINA, RN, MN JORESLYN P. BALA-AN, RN, MN, Ma.ed HELEN V. CORREA, RN,
MN, Ed.D.
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of the Dean
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN, MN, Ma.ed Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0091019 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: May 24, 2011 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 03879 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: Lifeline Member Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: VALIENTE, MARVIC JOHNEL JAVA__________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: ________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ___________
Year Admission in the Bachelor of Science in Nursing Program: June 2004____________________________________________________________
Year Graduated (BSN Program): October 14, 2009________________________________________________________________________________

I. MAJOR OPERATION
No Date of Case Name of Operation Type of Name of Name of Name of O.R. Scrub Supervised by: Name of
Diagnosis
. Operation No. Patient Performed Anesthesia Surgeon Hospital Nurse Faculty

3 January 12365 Palacio, Acute Explorator General Sebastian The Leonardo Gallardo,
16, 2009 6 Vicente Intestion y Lap Endotrache Tabuga Doctors’ RN
Secondary to Adhesiioly al Hospital YOLY H. PABILLO, RN, MN
Intestinal sis with Incorporate Date Signed:
PRC No.: 0088398
Tuberculosis One Drain d
Valid Until: February 12, 2012
and Tabes PNA No.: 061319
Mesenteries Valid Until: December 31, 2009

Prepared by: Noted by: Concurred by: Approved by:

MARVIC JOHNEL J. VALIENTE WILSIE A. BELECINA, RN, MN EDITHA L. BAYONETA, RN, MN HELEN V. CORREA, RN, MN, Ed.D.
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN, MN Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0125661 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: August 8, 2012 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 19677 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: Lifetime Member Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: VALIENTE, MARVIC JOHNEL JAVA__________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: ________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ___________
Year Admission in the Bachelor of Science in Nursing Program: June 2004____________________________________________________________
Year Graduated (BSN Program): October 14, 2009________________________________________________________________________________

I. MAJOR OPERATION
No Date of Case Name of Operation Type of Name of Name of Name of O.R. Scrub Supervised by: Name of
Diagnosis
. Operation No. Patient Performed Anesthesia Surgeon Hospital Nurse Faculty

5 March 1, 09- Yulatic, Alma Gravida 2 Primary Spinal Norma Calicdan Teresita L. Helen Jimenea, RN
2009 0276 Para2, Low Jalandoni TRINA P. PANTALEON, RN
Pregnancy Transvers Provincial Date Signed:
PRC No.: 0461440
Uterine Full e Hospital
Valid Until: March 22, 2010
Term; Frank Cesarean PNA No.: 044577
Breech Section Valid Until: October 31, 2010

Prepared by: Noted by: Concurred by: Approved by:

MARVIC JOHNEL J. VALIENTE WILSIE A. BELECINA, RN, MN MA. TERESA O. SEVERINO, RN, MAN HELEN V. CORREA, RN, MN, Ed.D.
 Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN, MAN Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0101938 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: April 27, 2011 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 174418 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: Lifetime Member Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: VALIENTE, MARVIC JOHNEL JAVA__________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: ________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ___________
Year Admission in the Bachelor of Science in Nursing Program: June 2004____________________________________________________________
Year Graduated (BSN Program): October 14, 2009________________________________________________________________________________

II. MINOR OPERATION

Date of Type of
No Case Name of Operation Name of Name of Name of O.R. Supervised by: Name of
Operatio Diagnosis Anesthesi
. No. Patient Performed Surgeon Hospital Scrub Nurse Faculty
n a

4 019870 Legame, Complte Tenorrhapy Local Shaun Jerry

36 Rene Transection, Borres Corazon Trayfalgar RAFAEL C. MARMOLEJO III, RN
Extensor Digitorum Locsin Date Signed:
Decembe Cummis Tendon, Montelibano PRC No.: 0260390
r 12, Hand, Left Memorial Valid Until: June 31, 2010
PNA No.: 045285
2008 Regional Valid Until: October 31, 2010
5 010951 Lizano, Lacerated Wound Suturing, Local Juan Del Rio Hospital Graciano
91 Romilo 2cm, 1st Digit, Wound, Mugar
Foot, Right Lacerated,
1st Digit,
Foot, Right
Prepared by: Noted by: Concurred by: Approved by:

MARVIC JOHNEL J. VALIENTE WILSIE A. BELECINA, RN, MN JORESLYN P. BALA-AN, RN, MN, Ma.ed HELEN V. CORREA, RN, MN,
Ed.D.
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN, MN, Ma.ed Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0091019 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: May 24, 2011 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 03879 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: Lifeline Member Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: VALIENTE, MARVIC JOHNEL JAVA__________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: ________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ___________
Year Admission in the Bachelor of Science in Nursing Program: June 2004____________________________________________________________
Year Graduated (BSN Program): October 14, 2009________________________________________________________________________________

II. MINOR OPERATION

Name of
No Date of Case Operation Type of Name of Name of Supervised by: Name of
Name of Patient Diagnosis O.R. Scrub
. Operation No. Performed Anesthesia Surgeon Hospital Faculty
Nurse

1 May 10, 10631 Aloro, Enrico Gatric Outlet Esophagu- Local Ric Lobaton The Doctors’
NESTOR IGNACIO D. TALAGON
2008 2 Obstruction Gastro Hospital JR., RN, PTRP
Secondary to Duodenoscopy Incorporated Date Signed:
Pyloro-Anral aand Biopsy PRC No.: 0263971
Valid Until: February 8, 2013
Mass PNA No.: 045622
Valid Until: October 31, 2010
2 10619 Banguanga,Kens Dysplsastic Closed General Jose Maria
2 hin Hip, Right, Reduction Endotrache Coruña
Status Post al
Release of
Soft Tissue
and
 Debridement
of
Acetabulum

Prepared by: Noted by: Concurred by: Approved by:

MARVIC JOHNEL J. VALIENTE
WILSIE A. BELECINA, RN, MN EDITHA L. BAYONETA, RN, MN HELEN V. CORREA, RN, MN, Ed.D.
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN, MN Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0125661 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: August 8, 2012 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 19677 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: Lifetime Member Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: VALIENTE, MARVIC JOHNEL JAVA__________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: ________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ___________
Year Admission in the Bachelor of Science in Nursing Program: June 2004____________________________________________________________
Year Graduated (BSN Program): October 14, 2009________________________________________________________________________________

V. CORD DRESSING
Case Gender of Supervised by: Name of Qualified
No. Date Performed Name of Baby Name of Mother Age Name of Hospital
No. Baby C.I.

2 124360 November 20, Alintana, Baby Female Alintana. 32 The Doctors’ Hospital
2008 Girl Jovelyn Incorporated MA. LEONORA S. GAMBOA, RN, MN
Date Signed:
PRC No.: 0240549
Valid Until: September 1, 2012
PNA No.: 044523
Valid Until: October 31, 2010

Prepared by: Noted by: Concurred by: Approved by:

MARVIC JOHNEL J. VALIENTE WILSIE A. BELECINA, RN, MN
Date Signed: _______________
Degree: RN, MN
a) PRC No. 0239072
Valid Until: February 8, 2012
b) PNA No. 045487
Valid Until: October 31, 2010
EDITHA L. BAYONETA, RN, MN
Date Signed: _______________
Degree: RN, MN
a) PRC No. 0125661
Valid Until: August 8 2012
b) PNA No. 19677
Valid Until: Lifetime Member
HELEN V. CORREA, RN, MN, Ed.D.
Date Signed: _______________
Degree: RN, MN, Ed. D.
a) PRC No. 56974
Valid Until: November 15, 2011
b) PNA No. 045219
Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: VALIENTE, MARVIC JOHNEL JAVA__________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: ________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ___________
Year Admission in the Bachelor of Science in Nursing Program: June 2004____________________________________________________________
Year Graduated (BSN Program): October 14, 2009________________________________________________________________________________

V. CORD DRESSING
Case Gender of Supervised by: Name of Qualified
No. Date Performed Name of Baby Name of Mother Age Name of Hospital
No. Baby C.I.

3 010986 February 19, Gustilo, Jonathan Male Gustilo, Sheena Mae 23

01 2009 Corazon Locsin
Montelibano Memorial MA. LEONORA S. GAMBOA, RN,
4 010986 February 19, Cañete, Arialyn Female Cañete, Jocelyn 24 Regional Hospital MN
23 2009 Date Signed:
PRC No.: 0240549
Valid Until: September 1, 2012
PNA No.: 044523
Valid Until: October 31, 2010

Prepared by: Noted by: Concurred by: Approved by:

MARVIC JOHNEL J. VALIENTE WILSIE A. BELECINA, RN, MN JORESLYN P. BALA-AN, RN, MN, Ma.ed HELEN V. CORREA, RN, MN,
Ed.D.
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN, MN, Ma.ed Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0091019 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: May 24, 2011 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 03879 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: Lifeline Member Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: VALIENTE, MARVIC JOHNEL JAVA__________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: ________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ___________
Year Admission in the Bachelor of Science in Nursing Program: June 2004____________________________________________________________
Year Graduated (BSN Program): October 14, 2009________________________________________________________________________________

III. ACTUAL DELIVERIES

Supervised by: Name of
Name of Date of Time of Gender of
No. Case No. Diagnosis Age Name of Hospital Type of Delivery Qualified
Mother Delivery Delivery Baby
C.I.

3 00-23-83 Pregnancy Malacay, 18 October 5:48 A.M Female

Uterine Full Cristie 26, 2008 Well Family Normal
Term, Gravida Midwife Clinic- Spontaneous Donna P. Javelona, RN
1 Para 1 Villamonte Vaginal Delivery Date Signed:
PRC No.: 0263971
Valid Until: February 8, 2013
4 00-25-30 Pregnancy Rubino, Charity 24 January 2:25 P.M Female PNA No.: 045622
Uterine Full 25, 2009 Normal Valid Until: October 31, 2010
Term, Gravida Spontaneous
1 Para 1 Vaginal Delivery
Prepared by: Noted by: Concurred by: Approved by:

MARVIC JOHNEL J. VALIENTE WILSIE A. BELECINA, RN, MN EDITH M. MONTIBOR, RM HELEN V. CORREA, RN, MN,
Ed.D.
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RM Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0084399 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: November 12, 2012 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: VALIENTE, MARVIC JOHNEL JAVA__________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: ________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ___________
Year Admission in the Bachelor of Science in Nursing Program: June 2004____________________________________________________________
Year Graduated (BSN Program): October 14, 2009________________________________________________________________________________

V. CORD DRESSING
Case Gender of Supervised by: Name of
No. Date Performed Name of Baby Name of Mother Age Name of Hospital
No. Baby Qualified C.I.

5 00-25- February 28, Cango, Jhian Male Cango, Jonah 23 Well Family Midwife Clinic-
66 2009 Gabriel Villamonte Donna P. Javelona, RN
Date Signed:
PRC No.: 0263971
Valid Until: February 8, 2013
PNA No.: 045622
Valid Until: October 31, 2010
Prepared by: Noted by: Concurred by: Approved by:

MARVIC JOHNEL J. VALIENTE WILSIE A. BELECINA, RN, MN EDITH M. MONTIBOR, RM HELEN V. CORREA, RN, MN,
Ed.D.
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RM Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0084399 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: November 12, 2012 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 045219
Valid Until: October 31, 2010 Valid Until: October 31, 2010

(FORMERLY WEST NEGROS COLLEGE)

COLLEGE OF NURSING
Bacolod City

Name of Student: VALIENTE, MARVIC JOHNEL JAVA__________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: ________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ___________
Year Admission in the Bachelor of Science in Nursing Program: June 2004____________________________________________________________
Year Graduated (BSN Program): October 14, 2009________________________________________________________________________________

II. MINOR OPERATION

Date of
No Case Name of Operation Type of Name of Name of Name of O.R. Supervised by: Name of
Operatio Diagnosis
. No. Patient Performed Anesthesia Surgeon Hospital Scrub Nurse Faculty
n

1 106312 Aloro, Enrico Gastric Outlet Esophago- Local Ric Lobaton Jerry
May 10, Obstruction Gastro Corazon Trayfalgar RAFAEL C. MARMOLEJO III, RN
2008 Secondary to Duodenosco Locsin Date Signed:
Pyloro-Antral Mass py Montelibano PRC No.: 0263971
Memorial Valid Until: February 8, 2013
PNA No.: 045622
2 106193 Banguanga, Dysplastic Hip, Closed General Jose Maria Regional Graciano Valid Until: October 31, 2010
Kenshin Right, S/P Release Reduction Endotrache Coru Hospital Mugar
of Soft Tissue and al
Debridement of
 Acetabulum

Prepared by: Noted by: Concurred by: Approved by:

MARVIC JOHNEL J. VALIENTE WILSIE A. BELECINA, RN, MN JORESLYN P. BALA-AN, RN, MN, Ma.ed HELEN V. CORREA, RN, MN,
Ed.D.
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN, MN, Ma.ed Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0091019 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: May 24, 2011 Valid Until: November 15, 2011
Valid Until: October 31, 2010

Name of Student: DUREZA,DEBBIE MARIEL LIRA________________________

Name & Address of School: West Negros University, Burgos Street, bacolod City_______
Accreditation Level (if any): _________________________________________________ Year Granted: _________________________
Date of School Program was Recognized: ____Effective_SY 1995 - 1996______________ Number: C-R- 013 S. 1995______ Year: ___1995_____
First Course (if any): ________________________________________ School Graduated From: ________________________ Year: ____________
Year Admission in the Bachelor of Science in Nursing Program: June 2005____________________________________________________________
Year Graduated (BSN Program): October 14, 2009___________________________________________________________________________________

II. MINOR OPERATION

Date of Type of
No Case Operation Name of Name of O.R. Supervised by: Name
Operatio Name of Patient Diagnosis Anesthesi Name of Hospital
. No. Performed Surgeon Scrub Nurse of Faculty
n a

2 January 090007 Lindayao,Jelmar Incised Wound, Suturing of Local Ma.Lalaine Ignacio Lacson Gina Garrido
Joemarie M. Jolo, RN
30,209 79 Gonzaga 4cm Long Cutting Wound Teorima Arroyo Sr. Date Signed:
the Nailbed, Left Memorial District Degree: RN
Thumb Hospital PRC No.: 0263127
Valid Until: June 4, 2012
PNA No.: 021544
Valid Until: October 31,
2010
Prepared by: Noted by: Concurred by: Approved by

DEBBIE MARIEL L. DUREZA WILSIE A. BELECINA, RN, MN ROSE MARY P. GAYARES, RN HELEN V. CORREA, RN, MN,
Ed.D.
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of the Dean
Date Signed: _______________ Date Signed: _______________ Date Signed: _______________
Degree: RN, MN Degree: RN Degree: RN, MN, Ed. D.
a) PRC No. 0239072 a) PRC No. 0034577 a) PRC No. 56974
Valid Until: February 8, 2012 Valid Until: December 25, 2011 Valid Until: November 15, 2011
b) PNA No. 045487 b) PNA No. 021546 b) PNA No. 045219
Valid Until: October31, 2010 Valid Until: October 31. 2010 Valid Until: October 31, 2010

Clinic