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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

MAJOR OPERATION ASSISTED


NO DATE OF CASE NAME OF OPERATION TYPE OF NAME OF
DIAGNOSIS NAME OF HOSPITAL
. OPERATION NO. PATIENT PERFORMED ANESTHESIA SURGEON

TERM OF PREGNANCY LOW


JANUARY 19, OGPIMININA, PRIMIGRAVIDA, PREMATURE CERVICAL DR. HELEN SAINT ANTHONY COLLEGE OF
1 11812700 SPINAL
2010 MARJORIE RUPTURE OF MEMEBRANE, CESAREAN BISNAR ROXAS CITY, INC. (HOSPITAL)
CEPHALOPELVIC DISPROPORTION SECTION

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

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

MAJOR OPERATION ASSISTED


NO DATE OF CASE NAME OF OPERATION NAME OF
DIAGNOSIS TYPE OF ANESTHESIA NAME OF HOSPITAL
. OPERATION NO. PATIENT PERFORMED SURGEON
SUBARACHNOID
DISTAL ABDOMINAL BLOCK AND SAN JUAN DE DIOS
MARCH 29, VALENZUELA, CHOLEDOCHO- DR. IGNACIO
1 268006 BILE DUCT CONTINUOUS EDUCATIONAL FOUNDATION,
2010 CRISTINA DUODENOSCOPY SAN GABRIEL
OBSTRUCTION EPIDURAL INC. (HOSPITAL)
ANESTHESIA
OPEN SUBARACHNOID
CHOLECYSTECTOMY BLOCK AND DR. SAN JUAN DE DIOS
MARCH 30, FERRER, JADID CHRONIC CALCULUS
2 218292 WITH CONTINUOUS ADELBERT EDUCATIONAL FOUNDATION,
2010 AMINAH CHOLECYSTITIS
INTRAOPERATIVE EPIDURAL SANTOS INC. (HOSPITAL)
CHOLANGIOGRAPHY ANESTHESIA
GENERAL ANESTHESIA
UPPER GASTRIC SAN JUAN DE DIOS
MARCH 31, EXPLORATORY AND CONTINUOUS DR. DANIEL
3 179795 ROBLES, JOSE INTESTINAL EDUCATIONAL FOUNDATION,
2010 LAPAROTOMY EPIDURAL ADVINCULA
BLEEDING INC. (HOSPITAL)
ANESTHESIA

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

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

MAJOR OPERATION ASSISTED


NO DATE OF CASE OPERATION TYPE OF NAME OF
NAME OF PATIENT DIAGNOSIS NAME OF HOSPITAL
. OPERATION NO. PERFORMED ANESTHESIA SURGEON

GRAVIDA 1 PARA 1 LOW CERVICAL


PREGNANCY UTERINE, 41 CESAREAN SECTION,
DE GUZMAN, DR. LUCINO SAINT ANTHONY COLLEGE OF
1 MAY 6, 2010 11812965 WEEKS AGE OF SEPTATECTOMY SPINAL
JAY-AN DELFIN ROXAS CITY, INC. (HOSPITAL)
GESTATION, FRANK WITH LIGATION OF
BREECH IN LABOR BLEEDERS

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

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

MINOR OPERATION ASSISTED


NO DATE OF NAME OF OPERATION TYPE OF NAME OF
CASE NO. DIAGNOSIS NAME OF HOSPITAL
. OPERATION PATIENT PERFORMED ANESTHESIA SURGEON

ABORTION 7-8 WEEKS


FEBRUARY GALERA, COMPLETION INTRAVENOU DR. HELEN SAINT ANTHONY COLLEGE OF
1 11812736 AGE OF GESTATION, NON
3, 2010 ANALYN CURETTAGE S SEDATION BISNAR ROXAS CITY, INC. (HOSPITAL)
INDUCED NON SEPTIC

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

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

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

MINOR OPERATION ASSISTED


NO DATE OF CASE OPERATION TYPE OF NAME OF
NAME OF PATIENT DIAGNOSIS NAME OF HOSPITAL
. OPERATION NO. PERFORMED ANESTHESIA SURGEON

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

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

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

MINOR OPERATION ASSISTED


NO DATE OF CASE OPERATION TYPE OF NAME OF
NAME OF PATIENT DIAGNOSIS NAME OF HOSPITAL
. OPERATION NO. PERFORMED ANESTHESIA SURGEON

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

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

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

MINOR OPERATION ASSISTED


NO DATE OF CASE TYPE OF NAME OF
NAME OF PATIENT DIAGNOSIS OPERATION PERFORMED NAME OF HOSPITAL
. OPERATION NO. ANESTHESIA SURGEON

EXCISION OF DR. MA.


DECLARO, SEBACEOUS CYST AT SAINT ANTHONY COLLEGE OF
1 JULY 3, 2010 60733 SEBACEOUS CYST AT LOCAL MERCEDES
STEPHENE THE POSTERIOR EAR ROXAS CITY, INC. (HOSPITAL)
THE POSTERIOR EAR ALTAVAS

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

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

PREGNANCY UTERINE SAINT ANTHONY COLLEGE NORMAL


00-56- SEPTEMBER 11,
2 FULLTERM GRAVIDA 1 GARCIA, FATIMA 20 8:25 PM MALE OF ROXAS CITY, INC. SPONTANEOUS
66 2010
PARA 1 (HOSPITAL)- COMMUNITY VAGINAL DELIVERY

PREGNANCY UTERINE SAINT ANTHONY COLLEGE NORMAL


00-54- PAGAYON, SEPTEMBER 19,
3 FULLTERM GRAVIDA 1 26 1:25 PM FEMALE OF ROXAS CITY, INC. SPONTANEOUS
91 GLADYS 2010
PARA 1 (HOSPITAL)- COMMUNITY VAGINAL DELIVERY

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

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

PREGNANCY UTERINE SAINT ANTHONY COLLEGE NORMAL


00-59- TRINIDAD, DECEMBER 31,
2 FULLTERM GRAVIDA 1 36 2:32 AM MALE OF ROXAS CITY, INC. SPONTANEOUS
83 RHODORA 2010
PARA 1 (HOSPITAL)- COMMUNITY VAGINAL DELIVERY

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

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

PREGNANCY UTERINE SAINT ANTHONY COLLEGE NORMAL


00-57- DORDAS, SEPTEMBER 5,
2 FULLTERM GRAVIDA 1 22 12:50 PM MALE OF ROXAS CITY, INC. SPONTANEOUS
03 MICHELLE 2010
PARA 1 (HOSPITAL)- COMMUNITY VAGINAL DELIVERY

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

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

PREGNANCY UTERINE SAINT ANTHONY COLLEGE NORMAL


00-59- FEBRUARY 16,
2 FULLTERM GRAVIDA 3 FERRER, EDELPA 25 12:49 AM FEMALE OF ROXAS CITY, INC. SPONTANEOUS
59 2011
PARA 2 (HOSPITAL)- COMMUNITY VAGINAL DELIVERY

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

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 39 SAN JUAN DE DIOS


NORMAL
1/7 WEEKS OF EDUCATIONAL
1 269670 DOMINGO, AIREN 23 MARCH 29, 2010 9:52 AM MALE SPONTANEOUS
GESTATION GRAVIDA 1 FOUNDATION, INC.
VAGINAL DELIVERY
PARA 1 (HOSPITAL)

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

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

SAINT ANTHONY COLLEGE OF


2 00-57-32 SEPTEMBER 20, 2010 OPOLENCIA, BABY BOY MALE OPOLENCIA, MARY ANN 18 ROXAS CITY, INC. (HOSPITAL)-
COMMUNITY

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

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
.

SAINT ANTHONY COLLEGE OF


1 61654 NOVEMBER 17, 2010 GUZMAN, BABY BOY MALE GUZMAN, AILEEN 35
ROXAS CITY, INC. (HOSPITAL)

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

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
.

SAN JUAN DE DIOS EDUCATIONAL


1 269966 APRIL 16, 2010 SUMERA, BABY GIRL FEMALE SUMERA, MELANIE 29
FOUNDATION, INC. (HOSPITAL)

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

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
.

SAINT ANTHONY COLLEGE OF


1 59495 JULY 10, 2010 BENLIRO, BABY GIRL FEMALE BENLIRO, RUTH 28
ROXAS CITY, INC. (HOSPITAL)

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

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: