SOUTHEAST ASIAN COLLEGE, INC.

COLLEGE OF NURSING

2 E. Rodriguez Sr. Avenue, Quezon City

BASED ON THE BOARD OF NURSING
Resolution No. 355 S-2004

Name of Student: FELIPE, TWYLA ALBUFERA______________________

Name & Address of School: SOUTHEAST ASIAN COLLEGE, INC. / 2 E. Rodriguez Sr. Avenue, Quezon City
Accreditation Level: (if any) ______________________________________ Year Granted_________________________________________
Date School/Program was Recognized: June 9, 1980 Number 53 Year 1980
First Course (if any): ________NOT APPLICABLE______________ School Graduated From: __________NOT APPLICABLE___________________ Year: ___NOT APPLICABLE__________
Year of Admission in the Bachelor of Science in Nursing Program: __2006___________________________________________________
Year Graduated (BSN Program): _________________________________________________________________________________

I. MAJOR OPERATIONS
Date of Case No. Name of Patient Diagnosis Operation Type of Name of Name of Hospital Supervised by (Name & Signature of
Operation Performed Anesthesia Surgeon Qualified Clinical Instructor)
1 10-10-09 09-664 David Josephine Gravida 1, Para 1 Caesarian section Spinal anesthesia Dr.Raquino Sta.Rita hospital
2
3
4
5

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

_______________________ _______________________ __________________________________ ________________________ _____________________________

Signature over printed name
of student
Signature over printed name of
Clinical Instructor
Date Signed: ______________
Degree: __________________
PRC no. _________________
Valid until: _______________
PNA no. _________________
Valid until: _______________
Signature over printed name of Chief Nurse
Date Signed: _______________________
Degree: ___________________________
PRC no. ___________________________
Valid until: _________________________
PNA no. ___________________________
Valid until: _________________________
Signature over printed name of
Clinical Coordinator
Date Signed: _____________
Degree: _________________
PRC no. _________________
Valid until: _______________
PNA no. _________________
Valid until: _______________
Signature over printed name of Dean
Date Signed: __________________
Degree: ______________________
PRC no. ______________________
Valid until: ____________________
PNA no. ______________________
Valid until: ____________________
 SOUTHEAST ASIAN COLLEGE, INC.
COLLEGE OF NURSING

2 E. Rodriguez Sr. Avenue, Quezon City

BASED ON THE BOARD OF NURSING
Resolution No. 355 S-2004

Name of Student: FELIPE, TWYLA ALBUFERA___________________________________________________________________________________________________________

Name & Address of School: SOUTHEAST ASIAN COLLEGE, INC. / 2 E. Rodriguez Sr. Avenue, Quezon City
Accreditation Level: (if any) ______________________________________ Year Granted_________________________________________
Date School/Program was Recognized: June 9, 1980 Number 53 Year 1980
First Course (if any): NOT APPLICABLE______________________ School Graduated From: __________NOT APPLICABLE___________________ Year: ___NOT APLLICABLE__________
Year of Admission in the Bachelor of Science in Nursing Program: _2006____________________________________________________
Year Graduated (BSN Program): _________________________________________________________________________________

II. MINOR OPERATIONS

Date of Case No. Name of Patient Diagnosis Operation Type of Name of Name of Hospital Supervised by (Name & Signature of
Operation Performed Anesthesia Surgeon Qualified Clinical Instructor)
1 August 6,2009 55563 Nacol Angeles Indirect inguinal Herniography Spinal Dr. Jason Pasay City General Mr.Marjon Gonzalez RN
hernia Anesthesia Quiambao Hospital
2 August 15,2009 55952 Villanueva, Elmer Acute Cholecystectomy Spinal Dr. Rolando Pasay City General Mr.Marjon Gonzalez RN
Cholecytstitis Anesthesia Zamudio Hospital
3 July 11, 2009 09-905 Joanna Eligio Mixed hemorrhoids hemorrhoidectomy Dr.Noel Lo Pasay City General Mr.Marjon Gonzalez RN
Arandia Hospital
4 January 17, 2010 72451 Vivian Asadon Abortion Completion IV Sedation Dr. Sheryll E. Pasay City General Mr.Marjon Gonzalez RN
Incomplete Curettage Pampleon Hospital
5

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

_______________________ _______________________ __________________________________ ________________________ _____________________________

Signature over printed name Signature over printed name of
of student Clinical Instructor
Date Signed: ______________
Degree: __________________
PRC no. _________________
Valid until: _______________
PNA no. _________________
Valid until: _______________
Signature over printed name of Chief Nurse Signature over printed name of
Clinical Coordinator
Date Signed: _______________________ Date Signed: _____________
Degree: ___________________________ Degree: _________________
PRC no. ___________________________ PRC no. _________________
Valid until: _________________________ Valid until: _______________
PNA no. ___________________________ PNA no. _________________
Valid until: _________________________ Valid until: _______________
Signature over printed name of Dean
Date Signed: __________________
Degree: ______________________
PRC no. ______________________
Valid until: ____________________
PNA no. ______________________
Valid until: ____________________
 SOUTHEAST ASIAN COLLEGE, INC.
COLLEGE OF NURSING

2 E. Rodriguez Sr. Avenue, Quezon City

BASED ON THE BOARD OF NURSING
Resolution No. 355 S-2004

Name of Student: FELIPE, TWYLA ALBUFERA__________________________________________________________________________________________________________

Name & Address of School: SOUTHEAST ASIAN COLLEGE, INC. / 2 E. Rodriguez Sr. Avenue, Quezon City
Accreditation Level: (if any) ______________________________________ Year Granted_________________________________________
Date School/Program was Recognized: June 9, 1980 Number 53 Year 1980
First Course (if any): _NOT APPLICABLE_____________________ School Graduated From: _NOT APPLICABLE____________________________ Year: ___NOT APPLICABLE__________
Year of Admission in the Bachelor of Science in Nursing Program: __2006___________________________________________________
Year Graduated (BSN Program): _________________________________________________________________________________

III. ACTUAL DELIVERIES

Case No. Diagnosis Name of Mother Age Date of Time of Gender of Baby Name of Hospital Type of Delivery Supervised by (Name & Signature of
Delivery Delivery Qualified Clinical Instructor)
1 100719 38 3/7 weeks of Enrique, Nerissa 29 years September 8:45am female Novaliches Lying In Normal Mrs. Fidelaila Manalo RN
gestation old 14,2010 spontaneous
Gravida 3 Para delivery
2
2 100723 39 2/7 weeks of Montel, Edna 32 years September 7:45 am female Novaliches Lying In Normal Mrs. Fidelaila Manalo RN
gestation old 15,2010 Spontaneous
Gravida 3 Para delivery
1
3 100743 37 4/7 weeks of Cababan, Yolanda 23 years September 21, 10:17 am male Novaliches Lying In Normal Mrs. Fidelaila Manalo RN
gestation old 2010 Spontaneous
Delivery
4
5

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

_______________________ _______________________ __________________________________ ________________________ _____________________________

Signature over printed name Signature over printed name of
of student Clinical Instructor
Date Signed: ______________
Degree: __________________
PRC no. _________________
Valid until: _______________
PNA no. _________________
Valid until: _______________
Signature over printed name of Chief Nurse Signature over printed name of
Clinical Coordinator
Date Signed: _______________________ Date Signed: _____________
Degree: ___________________________ Degree: _________________
PRC no. ___________________________ PRC no. _________________
Valid until: _________________________ Valid until: _______________
PNA no. ___________________________ PNA no. _________________
Valid until: _________________________ Valid until: _______________
Signature over printed name of Dean
Date Signed: __________________
Degree: ______________________
PRC no. ______________________
Valid until: ____________________
PNA no. ______________________
Valid until: ____________________
 SOUTHEAST ASIAN COLLEGE, INC.
COLLEGE OF NURSING

2 E. Rodriguez Sr. Avenue, Quezon City

BASED ON THE BOARD OF NURSING
Resolution No. 355 S-2004

Name of Student: _FELIPE, TWYLA ALBUFERA___________________________________________________________________________________________________________

Name & Address of School: SOUTHEAST ASIAN COLLEGE, INC. / 2 E. Rodriguez Sr. Avenue, Quezon City
Accreditation Level: (if any) ______________________________________ Year Granted_________________________________________
Date School/Program was Recognized: June 9, 1980 Number 53 Year 1980
First Course (if any): _NOT APPLICABLE_____________________ School Graduated From: __NOT APPLICABLE___________________________ Year: __NOT APPLICABLE___________
Year of Admission in the Bachelor of Science in Nursing Program: _2006____________________________________________________
Year Graduated (BSN Program): _________________________________________________________________________________

IV. DELIVERIES ASSISTED

Case No. Diagnosis Name of Mother Age Date of Time of Gender of Name of Hospital Type of Delivery Supervised by (Name & Signature of
Delivery Delivery Baby Qualified Clinical Instructor)
1 100724 40 weeks of Brian, Genevieve 27 years September 15, 10:41 am female Novaliches Lying In Normal Fidelaila Manalo RN
Gestation old 2010 spontaneous
Gravida 3 Para Delivery
1
2 09-659 Gravida 7, Datumamoy, Bom 32 years October 8, 2:05 pm female Normal
Para 1 old 2009 Spontaneous
Delivery
3
4
5

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

_______________________ _______________________ __________________________________ ________________________ _____________________________

Signature over printed name
of student
Signature over printed name of
Clinical Instructor
Date Signed: ______________
Degree: __________________
PRC no. _________________
Valid until: _______________
PNA no. _________________
Valid until: _______________
Signature over printed name of Chief Nurse
Date Signed: _______________________
Degree: ___________________________
PRC no. ___________________________
Valid until: _________________________
PNA no. ___________________________
Valid until: _________________________
Signature over printed name of
Clinical Coordinator
Date Signed: _____________
Degree: _________________
PRC no. _________________
Valid until: _______________
PNA no. _________________
Valid until: _______________
Signature over printed name of Dean
Date Signed: __________________
Degree: ______________________
PRC no. ______________________
Valid until: ____________________
PNA no. ______________________
Valid until: ____________________
 SOUTHEAST ASIAN COLLEGE, INC.
COLLEGE OF NURSING

2 E. Rodriguez Sr. Avenue, Quezon City

BASED ON THE BOARD OF NURSING
Resolution No. 355 S-2004

Name of Student: _____Felipe, Twyla Albufera_______________________________________________________________________________________________________

Name & Address of School: SOUTHEAST ASIAN COLLEGE, INC. / 2 E. Rodriguez Sr. Avenue, Quezon City
Accreditation Level: (if any) ______________________________________ Year Granted_________________________________________
Date School/Program was Recognized: June 9, 1980 Number 53 Year 1980
First Course (if any): __NOT APPLICABLE____________________ School Graduated From: __NOT APPLICABLE___________________________ Year: __NOT APPLICABLE___________
Year of Admission in the Bachelor of Science in Nursing Program: _2006____________________________________________________
Year Graduated (BSN Program): _________________________________________________________________________________

V. CORD DRESSING
Case No. Date Performed Name of Baby Gender of Baby Name of Mother Age Name of Hospital Supervised by (Name & Signature of Qualified Clinical
Instructor)
1
2
3
4
5

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

_______________________ _______________________ __________________________________ ________________________ _____________________________

Signature over printed name
of student
Signature over printed name of
Clinical Instructor
Date Signed: ______________
Degree: __________________
PRC no. _________________
Valid until: _______________
PNA no. _________________
Valid until: _______________
Signature over printed name of Chief Nurse
Date Signed: _______________________
Degree: ___________________________
PRC no. ___________________________
Valid until: _________________________
PNA no. ___________________________
Valid until: _________________________
Signature over printed name of
Clinical Coordinator
Date Signed: _____________
Degree: _________________
PRC no. _________________
Valid until: _______________
PNA no. _________________
Valid until: _______________
Signature over printed name of Dean
Date Signed: __________________
Degree: ______________________
PRC no. ______________________
Valid until: ____________________
PNA no. ______________________
Valid until: ____________________