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JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: a). PRC No.: 0074221
Valid Valid Until: Valid Until:
FLORA MAY R. CORTEL, RN Until: NOVEMBER 22, 2012 SEPTMBER 15, 2011
Signature Over Printed Name of b). PNA No.: b). PNA No.: b). PNA No.: 8002
Clinical Instructor Valid Valid Until: Valid Until:
Until: LIFETIME
Date signed:
Degree: c). ADPCN
BSN No. : 427
a). PRC No.: 0380456 Valid Until: MAY 31, 2011
Valid Until: MAY 17, 2014
b). PNA No.:
Valid Until:
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY
5800 CAPIZ, PHILIPPINES
Name of First Course (if
Student: BARGAS, JUDY CARATAO any) N/A
Name and Address of ST. ANTHONY COLLEGE OF ROXAS CITY, INC., San Roque Extension, School
School: Roxas City Graduated: N/A
Recognition/Accreditation Year of Admission in the
Level BSN : 2007
Date School/ Program was FEBRUARY 08, 1982 Number 012 Year 1981 Year Graduated from the BSN
Recognized: (Effectivity) Program 2011
JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN RODOLFO C. BORROMEO, RN, MAN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: BSN, MAN Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: 0232752 a). PRC No.: 0074221
Valid Valid Until: Valid Until:
MERIAM D. FLORES, RN Until: NOVEMBER 22, 2012 APRIL 9, 2014 SEPTMBER 15, 2011
Signature Over Printed Name of b). PNA No.: b). PNA No.: 25315 b). PNA No.: 8002
Clinical Instructor Valid Valid Until: Valid Until:
Until: LIFETIME LIFETIME
Date signed:
Degree: c). ADPCN
BSN No. : 427
a). PRC No.: 0153798 Valid Until: MAY 31, 2011
Valid Until: JUNE 25, 2012
b). PNA No.:
Valid Until:
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY
5800 CAPIZ, PHILIPPINES
Name of First Course (if
Student: BARGAS, JUDY CARATAO any) N/A
Name and Address of ST. ANTHONY COLLEGE OF ROXAS CITY, INC., San Roque Extension, School
School: Roxas City Graduated: N/A
Recognition/Accreditation Year of Admission in the
Level BSN : 2007
Date School/ Program was FEBRUARY 08, 1982 Number 012 Year 1981 Year Graduated from the BSN
Recognized: (Effectivity) Program 2011
JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: a). PRC No.: 0074221
Valid NOVEMBER 22, 2012 Valid Until: Valid Until: SEPTMBER 15, 2011
ANDREW D. BELUSO, RN Until:
Signature Over Printed Name of b). PNA No.: b). PNA No.: b). PNA No.: 8002
Clinical Instructor Valid Valid Until: Valid Until: LIFETIME
Until:
Date signed:
Degree: c). ADPCN 427
BSN No. :
a). PRC No.: 0106869 Valid Until: MAY 31, 2011
Valid Until: OCTOBER 17, 2011
b). PNA No.:
Valid Until:
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY
5800 CAPIZ, PHILIPPINES
Name of First Course (if
Student: BARGAS, JUDY CARATAO any) N/A
Name and Address of ST. ANTHONY COLLEGE OF ROXAS CITY, INC., San Roque Extension, School
School: Roxas City Graduated: N/A
Recognition/Accreditation Year of Admission in the
Level BSN : 2007
Date School/ Program was FEBRUARY 08, 1982 Number 012 Year 1981 Year Graduated from the BSN
Recognized: (Effectivity) Program 2011
SOLID MASS 10
FERNANDO, EXCISION OF SOLID DR. MA.
11812112 CENTIMETERS LEFT SAINT ANTHONY COLLEGE OF
2 JULY 9, 2010 MATTHEW MASS, LEFT UPPER GENERAL MERCEDES
6 UPPER ARM TO ROXAS CITY, INC. (HOSPITAL)
JAMES ARM ALTAVAS
CONSIDER LIPOSARCOMA
JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: a). PRC No.: 0074221
Valid NOVEMBER 22, 2012 Valid Until: Valid Until: SEPTMBER 15, 2011
FLORA MAY R. CORTEL, RN Until:
Signature Over Printed Name of b). PNA No.: b). PNA No.: b). PNA No.: 8002
Clinical Instructor Valid Valid Until: Valid Until: LIFETIME
Until:
Date signed:
Degree: BSN c). ADPCN 427
No. :
a). PRC No.: 0380456 Valid Until: MAY 31, 2011
Valid Until: MAY 17, 2014
b). PNA No.:
Valid Until:
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY
5800 CAPIZ, PHILIPPINES
Name of First Course (if
Student: BARGAS, JUDY CARATAO any) N/A
Name and Address of ST. ANTHONY COLLEGE OF ROXAS CITY, INC., San Roque Extension, School
School: Roxas City Graduated: N/A
Recognition/Accreditation Year of Admission in the
Level BSN : 2007
Date School/ Program was FEBRUARY 08, 1982 Number 012 Year 1981 Year Graduated from the BSN
Recognized: (Effectivity) Program 2011
DR. MA.
MAY 12, SAINT ANTHONY COLLEGE OF
1 42419 FUNDAR, ELSA MASS, LEFT BREAST INCISIONAL BIOPSY LOCAL MERCEDES
2010 ROXAS CITY, INC. (HOSPITAL)
ALTAVAS
JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: a). PRC No.: 0074221
Valid NOVEMBER 22, 2012 Valid Until: Valid Until: SEPTMBER 15, 2011
ANDREW D. BELUSO, RN Until:
Signature Over Printed Name of b). PNA No.: b). PNA No.: b). PNA No.: 8002
Clinical Instructor Valid Valid Until: Valid Until: LIFETIME
Until:
Date signed:
Degree: c). ADPCN 427
BSN No. :
a). PRC No.: 0106869 Valid Until: MAY 31, 2011
Valid Until: OCTOBER 17, 2011
b). PNA No.:
Valid Until:
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY
5800 CAPIZ, PHILIPPINES
Name of First Course (if
Student: BARGAS, JUDY CARATAO any) N/A
Name and Address of ST. ANTHONY COLLEGE OF ROXAS CITY, INC., San Roque Extension, School
School: Roxas City Graduated: N/A
Recognition/Accreditation Year of Admission in the
Level BSN : 2007
Date School/ Program was FEBRUARY 08, 1982 Number 012 Year 1981 Year Graduated from the BSN
Recognized: (Effectivity) Program 2011
LACERATED WOUND
SUTURING OF DR. GEMMA
APRIL 19, ARNAIZ, KEITH FRONTAL AREA SAN JUAN DE DIOS EDUCATIONAL
1 08069 LACERATED WOUND, LOCAL PATRICIA
2010 IRVINE SECONDARY TO HEAD FOUNDATION, INC. (HOSPITAL)
FRONTAL AREA TACACA
TRAUMA
JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN RODOLFO C. BORROMEO, RN, MAN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: BSN, MAN Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: 0232752 a). PRC No.: 0074221
Valid NOVEMBER 22, 2012 Valid Until: APRIL 9, 2014 Valid Until: SEPTMBER 15, 2011
MARK ALVIN A. ALISASIS, RN Until:
Signature Over Printed Name of b). PNA No.: b). PNA No.: 25315 b). PNA No.: 8002
Clinical Instructor Valid Valid Until: LIFETIME Valid Until: LIFETIME
Until:
Date signed:
Degree: c). ADPCN 427
BSN No. :
a). PRC No.: Valid Until: MAY 31, 2011
Valid Until:
b). PNA No.:
Valid Until:
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY
5800 CAPIZ, PHILIPPINES
Name of First Course (if
Student: BARGAS, JUDY CARATAO any) N/A
Name and Address of ST. ANTHONY COLLEGE OF ROXAS CITY, INC., San Roque Extension, School
School: Roxas City Graduated: N/A
Recognition/Accreditation Year of Admission in the
Level BSN : 2007
Date School/ Program was FEBRUARY 08, 1982 Number 012 Year 1981 Year Graduated from the BSN
Recognized: (Effectivity) Program 2011
JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: a). PRC No.: 0074221
Valid NOVEMBER 22, 2012 Valid Until: Valid Until:
RUBILYN B. SUMAYLO, RN Until: SEPTMBER 15, 2011
Signature Over Printed Name of b). PNA No.: b). PNA No.: b). PNA No.: 8002
Clinical Instructor Valid Valid Until: Valid Until:
Until: LIFETIME
Date signed:
Degree: c). ADPCN
BSN No. : 427
a). PRC No.: Valid Until: MAY 31, 2011
Valid Until: APRIL 8,
b). PNA No.:
Valid Until:
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY
5800 CAPIZ, PHILIPPINES
Name of First Course (if
Student: BARGAS, JUDY CARATAO any) N/A
Name and Address of ST. ANTHONY COLLEGE OF ROXAS CITY, INC., San Roque Extension, School
School: Roxas City Graduated: N/A
Recognition/Accreditation Year of Admission in the
Level BSN : 2007
Date School/ Program was FEBRUARY 08, 1982 Number 012 Year 1981 Year Graduated from the BSN
Recognized: (Effectivity) Program 2011
ACTUAL DELIVERIES
NO CASE TIME OF GENDER OF
DIAGNOSIS NAME OF MOTHER AGE DATE OF DELIVERY NAME OF HOSPITAL TYPE OF DELIVERY
. NO. DELIVERY BABY
PREGNANCY UTERINE SAINT ANTHONY COLLEGE NORMAL
00-56- ANTIQUERA, SEPTEMBER 3,
1 FULLTERM GRAVIDA 2 27 10:19 AM FEMALE OF ROXAS CITY, INC. SPONTANEOUS
47 CHRISTINE 2010
PARA 2 (HOSPITAL)- COMMUNITY VAGINAL DELIVERY
JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: a). PRC No.: 0074221
Valid NOVEMBER 22, 2012 Valid Until: Valid Until:
MERIAM D. FLORES, RN Until: SEPTMBER 15, 2011
Signature Over Printed Name of b). PNA No.: b). PNA No.: b). PNA No.: 8002
Clinical Instructor Valid Valid Until: Valid Until:
Until: LIFETIME
Date signed:
Degree: c). ADPCN
BSN No. : 427
a). PRC No.: 0153798 Valid Until: MAY 31, 2011
Valid Until: JUNE 25, 2012
b). PNA No.:
Valid Until:
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY
5800 CAPIZ, PHILIPPINES
Name of First Course (if
Student: BARGAS, JUDY CARATAO any) N/A
Name and Address of ST. ANTHONY COLLEGE OF ROXAS CITY, INC., San Roque Extension, School
School: Roxas City Graduated: N/A
Recognition/Accreditation Year of Admission in the
Level BSN : 2007
Date School/ Program was FEBRUARY 08, 1982 Number 012 Year 1981 Year Graduated from the BSN
Recognized: (Effectivity) Program 2011
ACTUAL DELIVERIES
NO CASE TIME OF GENDER OF
DIAGNOSIS NAME OF MOTHER AGE DATE OF DELIVERY NAME OF HOSPITAL TYPE OF DELIVERY
. NO. DELIVERY BABY
PREGNANCY UTERINE SAINT ANTHONY COLLEGE NORMAL
00-59- BERMUDO, DECEMBER 20,
1 FULLTERM GRAVIDA 5 33 4:27 PM MALE OF ROXAS CITY, INC. SPONTANEOUS
86 KAREEN 2010
PARA 2 (HOSPITAL)- COMMUNITY VAGINAL DELIVERY
JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: a). PRC No.: 0074221
Valid NOVEMBER 22, 2012 Valid Until: Valid Until:
MARK ALVIN A. ALISASIS, RN Until: SEPTMBER 15, 2011
Signature Over Printed Name of b). PNA No.: b). PNA No.: b). PNA No.: 8002
Clinical Instructor Valid Valid Until: Valid Until:
Until: LIFETIME
Date signed:
Degree: c). ADPCN
BSN No. : 427
a). PRC No.: Valid Until: MAY 31, 2011
Valid Until:
b). PNA No.:
Valid Until:
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY
5800 CAPIZ, PHILIPPINES
Name of First Course (if
Student: BARGAS, JUDY CARATAO any) N/A
Name and Address of ST. ANTHONY COLLEGE OF ROXAS CITY, INC., San Roque Extension, School
School: Roxas City Graduated: N/A
Recognition/Accreditation Year of Admission in the
Level BSN : 2007
Date School/ Program was FEBRUARY 08, 1982 Number 012 Year 1981 Year Graduated from the BSN
Recognized: (Effectivity) Program 2011
DELIVERIES ASSISTED
NO CASE TIME OF GENDER OF
DIAGNOSIS NAME OF MOTHER AGE DATE OF DELIVERY NAME OF HOSPITAL TYPE OF DELIVERY
. NO. DELIVERY BABY
PREGNANCY UTERINE SAINT ANTHONY COLLEGE NORMAL
00-56- SENOPE, MA. SEPTEMBER 4,
1 FULLTERM GRAVIDA 1 23 9:10 PM MALE OF ROXAS CITY, INC. SPONTANEOUS
94 ATHELA 2010
PARA 1 (HOSPITAL)- COMMUNITY VAGINAL DELIVERY
JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: a). PRC No.: 0074221
Valid NOVEMBER 22, 2012 Valid Until: Valid Until:
MERIAM D. FLORES, RN Until: SEPTMBER 15, 2011
Signature Over Printed Name of b). PNA No.: b). PNA No.: b). PNA No.: 8002
Clinical Instructor Valid Valid Until: Valid Until:
Until: LIFETIME
Date signed:
Degree: c). ADPCN
BSN No. : 427
a). PRC No.: 0153798 Valid Until: MAY 31, 2011
Valid Until: JUNE 25, 2012
b). PNA No.:
Valid Until:
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY
5800 CAPIZ, PHILIPPINES
Name of First Course (if
Student: BARGAS, JUDY CARATAO any) N/A
Name and Address of ST. ANTHONY COLLEGE OF ROXAS CITY, INC., San Roque Extension, School
School: Roxas City Graduated: N/A
Recognition/Accreditation Year of Admission in the
Level BSN : 2007
Date School/ Program was FEBRUARY 08, 1982 Number 012 Year 1981 Year Graduated from the BSN
Recognized: (Effectivity) Program 2011
DELIVERIES ASSISTED
NO CASE TIME OF GENDER OF
DIAGNOSIS NAME OF MOTHER AGE DATE OF DELIVERY NAME OF HOSPITAL TYPE OF DELIVERY
. NO. DELIVERY BABY
PREGNANCY UTERINE SAINT ANTHONY COLLEGE NORMAL
00-59- MAGBANUA, DECEMBER 29,
1 FULLTERM GRAVIDA 1 25 12:15 PM MALE OF ROXAS CITY, INC. SPONTANEOUS
30 SHARON 2010
PARA 1 (HOSPITAL)- COMMUNITY VAGINAL DELIVERY
JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: a). PRC No.: 0074221
Valid NOVEMBER 22, 2012 Valid Until: Valid Until:
MARK ALVIN A. ALISASIS, RN Until: SEPTMBER 15, 2011
Signature Over Printed Name of b). PNA No.: b). PNA No.: b). PNA No.: 8002
Clinical Instructor Valid Valid Until: Valid Until:
Until: LIFETIME
Date signed:
Degree: c). ADPCN
BSN No. : 427
a). PRC No.: Valid Until: MAY 31, 2011
Valid Until:
b). PNA No.:
Valid Until:
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY
5800 CAPIZ, PHILIPPINES
Name of First Course (if
Student: BARGAS, JUDY CARATAO any) N/A
Name and Address of ST. ANTHONY COLLEGE OF ROXAS CITY, INC., San Roque Extension, School
School: Roxas City Graduated: N/A
Recognition/Accreditation Year of Admission in the
Level BSN : 2007
Date School/ Program was FEBRUARY 08, 1982 Number 012 Year 1981 Year Graduated from the BSN
Recognized: (Effectivity) Program 2011
DELIVERIES ASSISTED
NO CASE TIME OF GENDER OF
DIAGNOSIS NAME OF MOTHER AGE DATE OF DELIVERY NAME OF HOSPITAL TYPE OF DELIVERY
. NO. DELIVERY BABY
JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN RODOLFO C. BORROMEO, RN, MAN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: BSN, MAN Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: 0232752 a). PRC No.: 0074221
Valid NOVEMBER 22, 2012 Valid Until: APRIL 9, 2014 Valid Until:
MERIAM D. FLORES, RN Until: SEPTMBER 15, 2011
Signature Over Printed Name of b). PNA No.: b). PNA No.: 25315 b). PNA No.: 8002
Clinical Instructor Valid Valid Until: LIFETIME Valid Until:
Until: LIFETIME
Date signed:
Degree: c). ADPCN
BSN No. : 427
a). PRC No.: 0153798 Valid Until: MAY 31, 2011
Valid Until: JUNE 25, 2012
b). PNA No.:
Valid Until:
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY
5800 CAPIZ, PHILIPPINES
Name of First Course (if
Student: BARGAS, JUDY CARATAO any) N/A
Name and Address of ST. ANTHONY COLLEGE OF ROXAS CITY, INC., San Roque Extension, School
School: Roxas City Graduated: N/A
Recognition/Accreditation Year of Admission in the
Level BSN : 2007
Date School/ Program was FEBRUARY 08, 1982 Number 012 Year 1981 Year Graduated from the BSN
Recognized: (Effectivity) Program 2011
CORD DRESSING
NO
CASE NO. DATE PERFORMED NAME OF BABY GENDER OF BABY NAME OF MOTHER AGE NAME OF HOSPITAL
.
SAINT ANTHONY COLLEGE OF
1 00-57-17 SEPTEMBER 12, 2010 CURATCHO, BABY BOY MALE CURATCHO, RIZALLY 33 ROXAS CITY, INC. (HOSPITAL)-
COMMUNITY
JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: a). PRC No.: 0074221
Valid NOVEMBER 22, 2012 Valid Until: Valid Until:
MERIAM D. FLORES, RN Until: SEPTMBER 15, 2011
Signature Over Printed Name of b). PNA No.: b). PNA No.: b). PNA No.: 8002
Clinical Instructor Valid Valid Until: Valid Until:
Until: LIFETIME
Date signed:
Degree: c). ADPCN
BSN No. : 427
a). PRC No.: 0153798 Valid Until: MAY 31, 2011
Valid Until: JUNE 25, 2012
b). PNA No.:
Valid Until:
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY
5800 CAPIZ, PHILIPPINES
Name of First Course (if
Student: BARGAS, JUDY CARATAO any) N/A
Name and Address of ST. ANTHONY COLLEGE OF ROXAS CITY, INC., San Roque Extension, School
School: Roxas City Graduated: N/A
Recognition/Accreditation Year of Admission in the
Level BSN : 2007
Date School/ Program was FEBRUARY 08, 1982 Number 012 Year 1981 Year Graduated from the BSN
Recognized: (Effectivity) Program 2011
CORD DRESSING
NO
CASE NO. DATE PERFORMED NAME OF BABY GENDER OF BABY NAME OF MOTHER AGE NAME OF HOSPITAL
.
JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: a). PRC No.: 0074221
Valid NOVEMBER 22, 2012 Valid Until: Valid Until:
MERIAM D. FLORES, RN Until: SEPTMBER 15, 2011
Signature Over Printed Name of b). PNA No.: b). PNA No.: b). PNA No.: 8002
Clinical Instructor Valid Valid Until: Valid Until:
Until: LIFETIME
Date signed:
Degree: c). ADPCN
BSN No. : 427
a). PRC No.: 0153798 Valid Until: MAY 31, 2011
Valid Until: JUNE 25, 2012
b). PNA No.:
Valid Until:
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY
5800 CAPIZ, PHILIPPINES
Name of First Course (if
Student: BARGAS, JUDY CARATAO any) N/A
Name and Address of ST. ANTHONY COLLEGE OF ROXAS CITY, INC., San Roque Extension, School
School: Roxas City Graduated: N/A
Recognition/Accreditation Year of Admission in the
Level BSN : 2007
Date School/ Program was FEBRUARY 08, 1982 Number 012 Year 1981 Year Graduated from the BSN
Recognized: (Effectivity) Program 2011
CORD DRESSING
NO
CASE NO. DATE PERFORMED NAME OF BABY GENDER OF BABY NAME OF MOTHER AGE NAME OF HOSPITAL
.
JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN RODOLFO C. BORROMEO, RN, MAN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: BSN, MAN Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: 0232752 a). PRC No.: 0074221
Valid NOVEMBER 22, 2012 Valid Until: Valid Until:
WILA C. VALLES, RN Until: APRIL 9, 2014 SEPTMBER 15, 2011
Signature Over Printed Name of b). PNA No.: b). PNA No.: 25315 b). PNA No.: 8002
Clinical Instructor Valid Valid Until: Valid Until:
Until: LIFETIME LIFETIME
Date signed:
Degree: c). ADPCN
BSN No. : 427
a). PRC No.: Valid Until: MAY 31, 2011
Valid Until:
b). PNA No.:
Valid Until:
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY
5800 CAPIZ, PHILIPPINES
Name of First Course (if
Student: BARGAS, JUDY CARATAO any) N/A
Name and Address of ST. ANTHONY COLLEGE OF ROXAS CITY, INC., San Roque Extension, School
School: Roxas City Graduated: N/A
Recognition/Accreditation Year of Admission in the
Level BSN : 2007
Date School/ Program was FEBRUARY 08, 1982 Number 012 Year 1981 Year Graduated from the BSN
Recognized: (Effectivity) Program 2011
CORD DRESSING
NO
CASE NO. DATE PERFORMED NAME OF BABY GENDER OF BABY NAME OF MOTHER AGE NAME OF HOSPITAL
.
JUDY C. BARGAS KATHERINE C. BENGAN, RN, MSN SR. EDITHA A. BAGAYAUA, DC, RN, MAN
Signature Over Printed Name of Student Signature Over Printed Name of Clinical Signature Over Printed Name of Chief Nurse Signature Over Printed Name of Dean
Coordinator
Date Signed: Date Signed: Date Signed:
Supervised by: Degree: BSN, MSN Degree: Degree: BSN, MAN
a). PRC No.: 0295743 a). PRC No.: a). PRC No.: 0074221
Valid NOVEMBER 22, 2012 Valid Until: Valid Until:
RUBILYN B. SUMAYLO, RN Until: SEPTMBER 15, 2011
Signature Over Printed Name of b). PNA No.: b). PNA No.: b). PNA No.: 8002
Clinical Instructor Valid Valid Until: Valid Until:
Until: LIFETIME
Date signed:
Degree: c). ADPCN
BSN No. : 427
a). PRC No.: Valid Until: MAY 31, 2011
Valid Until:
b). PNA No.:
Valid Until: