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St. Paul University Philippines School of Health Sciences, Mabini Street, Tuguegarao City, Philippines. Accreditation Level (if any) : PAASCU LEVEL III________________________________ Date School / Program was Recognized : _________.
St. Paul University Philippines School of Health Sciences, Mabini Street, Tuguegarao City, Philippines. Accreditation Level (if any) : PAASCU LEVEL III________________________________ Date School / Program was Recognized : _________.
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St. Paul University Philippines School of Health Sciences, Mabini Street, Tuguegarao City, Philippines. Accreditation Level (if any) : PAASCU LEVEL III________________________________ Date School / Program was Recognized : _________.
Авторское право:
Attribution Non-Commercial (BY-NC)
Доступные форматы
Скачайте в формате DOCX, PDF, TXT или читайте онлайн в Scribd
Name of Student : ________________________________________________________________________________________________________________________________
Name & Address of School : St. Paul University Philippines, Mabini Street, Tuguegarao City_____________________________________________________________________ Accreditation Level (if any) : PAASCU LEVEL III______________________________________ Year Granted : ___________________________________________________ Date School / Program was Recognized : ______________________________________________ Number : ___________________________ Year : ______________________ First Course (if any) : ________________________________________ School Graduated From : ____________________________________ Year : ______________________ Year of Admission in the Bachelor of Science in Nursing Program : _________________________________________________________________________________________ Year Graduate (BSN Program) : _____________________________________________________________________________________________________________________
MAJOR OPERATIONS
Date of Name of Operation Type of Name of Name of Name of O.R.
No. Case No. Diagnosis Name of C.I. Operation Patient Performed Anesthesia Surgeon Hospital Scrub Nurse 1
Prepared by : Concurred by : Noted by : Approved by :
_______________________ ____________________________________ __________________________________________ SR. TRECELLA MAY MACALAM, SPC
Signature over Printed Name Signature over Printed Name of Chief Nurse Signature over Printed Name of Clinical Coordinator Signature over Printed Name of Dean Date Signed : ________________________ Date Signed : _______________________________ Date Signed : _______________________ Degree : ____________________________ Degree : ___________________________________ Degree : ___________________________ a) PRC No. ____________________ a.) PRC No. ____________________________ a.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________________ Valid Until: __________________ b) PNA No. ____________________ b.) PNA No. ____________________________ b.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________________ Valid Until: __________________ c) ANSAP No. _________________ c.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________ St. Paul University Philippines School of Health Sciences Name of Student : __________________ ______________________________________________________________________________________________________________ Name & Address of School : St. Paul University Philippines, Mabini Street, Tuguegarao City_____________________________________________________________________ Accreditation Level (if any) : PAASCU LEVEL III______________________________________ Year Granted : ___________________________________________________ Date School / Program was Recognized : ______________________________________________ Number : ___________________________ Year : ______________________ First Course (if any) : ________________________________________ School Graduated From : ____________________________________ Year : ______________________ Year of Admission in the Bachelor of Science in Nursing Program : _________________________________________________________________________________________ Year Graduate (BSN Program) : _____________________________________________________________________________________________________________________
MINOR OPERATIONS
Date of Name of Operation Type of Name of Name of Name of O.R.
No. Case No. Diagnosis Name of C.I. Operation Patient Performed Anesthesia Surgeon Hospital Scrub Nurse 1
Prepared by : Concurred by : Noted by : Approved by :
_______________________ ____________________________________ __________________________________________ SR. TRECELLA MAY MACALAM, SPC
Signature over Printed Name Signature over Printed Name of Chief Nurse Signature over Printed Name of Clinical Coordinator Signature over Printed Name of Dean Date Signed : ________________________ Date Signed : _______________________________ Date Signed : _______________________ Degree : ____________________________ Degree : ___________________________________ Degree : ___________________________ a) PRC No. ____________________ a.) PRC No. ____________________________ a.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________________ Valid Until: __________________ b) PNA No. ____________________ b.) PNA No. ____________________________ b.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________________ Valid Until: __________________ c) ANSAP No. _________________ c.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________
St. Paul University Philippines
School of Health Sciences
Name of Student : ________________________________________________________________________________________________________________________________
Name & Address of School : St. Paul University Philippines, Mabini Street, Tuguegarao City_____________________________________________________________________ Accreditation Level (if any) : PAASCU LEVEL III______________________________________ Year Granted : ___________________________________________________ Date School / Program was Recognized : ______________________________________________ Number : ___________________________ Year : ______________________ First Course (if any) : ________________________________________ School Graduated From : ____________________________________ Year : ______________________ Year of Admission in the Bachelor of Science in Nursing Program : _________________________________________________________________________________________ Year Graduate (BSN Program) : _____________________________________________________________________________________________________________________
ACTUAL DELIVERIES
Date of Time of Gender Name of Type of Supervised by :
No. Case No. Diagnosis Name of Mother Age Delivery Delivery of Baby Hospital Delivery Name & Signature of Qualified C.I. 1
Prepared by : Concurred by : Noted by : Approved by :
_______________________ ____________________________________ __________________________________________ SR. TRECELLA MAY MACALAM, SPC
Signature over Printed Name Signature over Printed Name of Chief Nurse Signature over Printed Name of Clinical Coordinator Signature over Printed Name of Dean Date Signed : ________________________ Date Signed : _______________________________ Date Signed : _______________________ Degree : ____________________________ Degree : ___________________________________ Degree : ___________________________ a) PRC No. ____________________ a.) PRC No. ____________________________ a.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________________ Valid Until: __________________ b) PNA No. ____________________ b.) PNA No. ____________________________ b.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________________ Valid Until: __________________ c) ANSAP No. _________________ c.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________
St. Paul University Philippines
School of Health Sciences
Name of Student : ________________________________________________________________________________________________________________________________
Name & Address of School : St. Paul University Philippines, Mabini Street, Tuguegarao City_____________________________________________________________________ Accreditation Level (if any) : PAASCU LEVEL III______________________________________ Year Granted : ___________________________________________________ Date School / Program was Recognized : ______________________________________________ Number : ___________________________ Year : ______________________ First Course (if any) : ________________________________________ School Graduated From : ____________________________________ Year : ______________________ Year of Admission in the Bachelor of Science in Nursing Program : _________________________________________________________________________________________ Year Graduate (BSN Program) : _____________________________________________________________________________________________________________________
DELIVERIES ASSISTED
Date of Time of Gender Name of Type of Supervised by :
No. Case No. Diagnosis Name of Mother Age Delivery Delivery of Baby Hospital Delivery Name & Signature of Qualified C.I. 1
Prepared by : Concurred by : Noted by : Approved by :
_______________________ ____________________________________ __________________________________________ SR. TRECELLA MAY MACALAM, SPC
Signature over Printed Name Signature over Printed Name of Chief Nurse Signature over Printed Name of Clinical Coordinator Signature over Printed Name of Dean Date Signed : ________________________ Date Signed : _______________________________ Date Signed : _______________________ Degree : ____________________________ Degree : ___________________________________ Degree : ___________________________ a) PRC No. ____________________ a.) PRC No. ____________________________ a.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________________ Valid Until: __________________ b) PNA No. ____________________ b.) PNA No. ____________________________ b.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________________ Valid Until: __________________ c) ANSAP No. _________________ c.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________
St. Paul University Philippines
School of Health Sciences
Name of Student : ________________________________________________________________________________________________________________________________
Name & Address of School : St. Paul University Philippines, Mabini Street, Tuguegarao City_____________________________________________________________________ Accreditation Level (if any) : PAASCU LEVEL III______________________________________ Year Granted : ___________________________________________________ Date School / Program was Recognized : ______________________________________________ Number : ___________________________ Year : ______________________ First Course (if any) : ________________________________________ School Graduated From : ____________________________________ Year : ______________________ Year of Admission in the Bachelor of Science in Nursing Program : _________________________________________________________________________________________ Year Graduate (BSN Program) : _____________________________________________________________________________________________________________________
NEWBORN CARE
Date of Time of Gender Name of Type of Supervised by :
No. Case No. Diagnosis Name of Mother Age Delivery Delivery of Baby Hospital Delivery Name & Signature of Qualified C.I. 1
Prepared by : Concurred by : Noted by : Approved by :
_______________________ ____________________________________ __________________________________________ SR. TRECELLA MAY MACALAM, SPC
Signature over Printed Name Signature over Printed Name of Chief Nurse Signature over Printed Name of Clinical Coordinator Signature over Printed Name of Dean Date Signed : ________________________ Date Signed : _______________________________ Date Signed : _______________________ Degree : ____________________________ Degree : ___________________________________ Degree : ___________________________ a) PRC No. ____________________ a.) PRC No. ____________________________ a.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________________ Valid Until: __________________ b) PNA No. ____________________ b.) PNA No. ____________________________ b.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________________ Valid Until: __________________ c) ANSAP No. _________________ c.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________
St. Paul University Philippines
School of Health Sciences
Name of Student : ________________________________________________________________________________________________________________________________
Name & Address of School : St. Paul University Philippines, Mabini Street, Tuguegarao City_____________________________________________________________________ Accreditation Level (if any) : PAASCU LEVEL III______________________________________ Year Granted : ___________________________________________________ Date School / Program was Recognized : ______________________________________________ Number : ___________________________ Year : ______________________ First Course (if any) : ________________________________________ School Graduated From : ____________________________________ Year : ______________________ Year of Admission in the Bachelor of Science in Nursing Program : _________________________________________________________________________________________ Year Graduate (BSN Program) : _____________________________________________________________________________________________________________________
CORD DRESSING
Date of Time of Gender Name of Type of Supervised by :
No. Case No. Diagnosis Name of Mother Age Delivery Delivery of Baby Hospital Delivery Name & Signature of Qualified C.I. 1
Prepared by : Concurred by : Noted by : Approved by :
_______________________ ____________________________________ __________________________________________ SR. TRECELLA MAY MACALAM, SPC
Signature over Printed Name Signature over Printed Name of Chief Nurse Signature over Printed Name of Clinical Coordinator Signature over Printed Name of Dean Date Signed : ________________________ Date Signed : _______________________________ Date Signed : _______________________ Degree : ____________________________ Degree : ___________________________________ Degree : ___________________________ a) PRC No. ____________________ a.) PRC No. ____________________________ a.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________________ Valid Until: __________________ b) PNA No. ____________________ b.) PNA No. ____________________________ b.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________________ Valid Until: __________________ c) ANSAP No. _________________ c.) PRC No. ____________________ Valid Until: _________________ Valid Until: __________________