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of Hospital offering IV Training: Date of IV Training Program Attended: JOHN MARK F. GAN MMMH & MC October 19-21 PRC Number: On the Process Provider No. 192 Venue: Training Center MMMH & MC
I.
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luer Lock Gauge 18 1L luer Lock Gauge 18 250ml Luer Lock Gauge 20 1L 41 ugtts 14 ugtts 0690031 0122079 33 ugtts 0690031
II.
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Serous carcinoma, moderately differentiated, endometrium s/p manual evacuationof uterine content biopsy
III.
Admninistraion and Maintaining of Blood and Blood Components ( 2 Nurses in One Blood Transfusion Administration) Patient Name of the patient Age Date Time Volume/ IV Type of Cannula No. Blood Type/ insertion Components/ Rate 450cc/ B+/ PRBC/
Diagnosis
License No.
641745
Ismaelda Erice
52
10-29-12
7:30 PM
Left cephalic