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REPUBLIC OF THE PHILIPPINES

PROFESSIONAL REGULATION COMMISSION


MANILA
Name of the Student: Ryan B. Molina_________
Name & Address of the School: Martinez Memorial Colleges, 198 A. Mabini Street, Maypajo Caloocan City
Accreditation level (if any): ______________________________ Year Granted: _____________
Date School/Program was recognized: June 09, 1980_____ Number: _80 series of 1980___
First Course (if any: ________ School Graduated from: _ Year: ______________
Year of Admission in the Bachelor of Science in Nursing Program: 2006__________
Year Graduated (BSN Program): 2008____________

MINOR OPERATIONS

No. Date of Case Name of Patient Diagnosis Operation Performed Type of Name of Surgeon Name of Hospital Name of O.R. Scrub Nurse Signature of O.R.
Operation Number Anesthesia Scrub Nurse
1
Spinal Dra. Gale Santos Martinez Memorial Mrs. Doris B. Balagtas, RN, RM,
July 06, 2006 267 Belinda, Manio Incomplete Abortion Dilatation and Curettage
MD Hospital MAN
2
Lacerated Wound Left Foot Dr. Fernando Pagamutang Bayan ng Mr. Alexander P. Galang, RN,
December 23, 0675415 Bengson, Romulo Suture Local
3.0 cm Mandapat MD Malabon MAN
2006
3 December 24, 0675461 Salomeia, Lacerated Wound Left Ear Suture Local Dr. Fernando Mr. Alexander P. Galang, RN,
2006 Benedicto lobe 2.0cm Mandapat MD Pagamutang Bayan ng MAN
Malabon
4
February 20,
Victorion, Wound Exploration on Left Dr. Isodoro Martinez Memorial Mrs. Doris B. Balagtas, RN, RM,
2007 128 Hematoma on the Left Arm Spinal
Fernando Arm Mendoza MD Hospital MAN

5
Dra. Gale Santos Martinez Memorial Mrs. Doris B. Balagtas, RN, RM,
May 05, 2008 124 Ludovice , Gemma Threatened Abortion Dilatation and Curettage Spinal
MD Hospital MAN

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

DORIS B. BALAGTAS ALEXANDER P. GALANG NENITA T. CRUZ BENJAMIN A. DE GUZMAN MA. THERESA R. PISCASIO NEIL G. CABBO
Signature over printed name of Signature over printed name of Signature over printed name of Signature over printed name of Signature over printed name of Signature over printed name
of Clinical Instructor Clinical Instructor Chief Nurse Chief Nurse Clinical Coordinator of the College Dean
Date Signed: Date Signed: Date Signed: Date Signed: Date Signed: Date Signed:
Degree: RN,RM, MAN Degree: RN, MAN Degree: RN, MAN Degree: RN,RM, MAN Degree: RN, MAN Degree: RN, MSN
License: PRC #0154999 License: PRC # 0340115 License: PRC # 0147668 License: PRC # 100631 License: PRC # 0144845 License: PRC # 0183074
Valid Until: December 2010 Valid Until: December 11, 2009 Valid Until: January 10, 2010 Valid Until: January 28, 2010 Valid Until: September 2010 Valid Until: May 2011
PNA No.: 025550 PNA No.: 113 PNA No.: 25532 PNA No.: 18088 PNA No.: 2433 PNA No.: 19067
Valid Until: December 2009 Valid Until: Lifetime Member Valid Until: December 2009 Valid Until: Lifetime Member Valid Until: Lifetime Member Valid Until: Lifetime Member