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School of Nursing Barangay San Miguel, Iligan City 9200 Phone No.(063) 221-9219, Fax No. (063) 223-2114, mshnet@yahoo.com Accredited By: Association of Christian Schools, Colleges and Universities Accrediting Agency, Incorporated Accreditation Level: Level II, April 29, 2011 April 2014 Accredited By: Adventist Accrediting Association Accreditation Level: Level II, October 4, 2010-December 31, 2012 IMMEDIATE NEWBORN CORD CARE in:Adventist Medical Center, Barangay San Miguel, Iligan City Lanao del Norte Provincial Hospital, Baroy, Lanao del Norte Hospital/Home/Lying-in, Municipality/City/Province Prepared by: Printed name and Signature of Student: CRISTINA L. JAYSON Date Performed and Time Started Patients INITIAL Only Case Number (not applicable for Birthing/Lying-in Clinics/Homes) Baby Boy M 199353 Immediate Newborn Cord Care PERFORMED Indicate where performed e.g. D.R., Nursery, Nicu, or Home Nurse on Duty (Name and Signature) (If Midwife on Duty, Signature Not Required)
Cristine Faith G. Damas, RN PRC Number: 0441143 Valid Until: July 7, 2016 Eunice Lan S. Ardiente, RN PRC Number: 0714486 Valid Until: October 19, 2017 Nia Mae D. Abarquez, RN PRC Number: 0651914 Valid Until: January 1, 2016
Lucy May L. Bucayan, MN, RN PRC Number: 0193232 Valid Until: May 25, 2016 Lucy May L. Bucayan, MN, RN PRC Number: 0193232 Valid Until: May 25, 2016 Daverly M. Caeda, MN, RN PRC Number: 0364265 Valid Until: April 28, 2016
Noted by: EVALYN M. LECCIONES, MN, RN (Print Name and Signature) Clinical Coordinator, PRC I.D No.: 0245303 Valid Until:May 9, 2015 Date document is signed: ________ Time:______________ Please specify Highest Nursing Degree Earned: Master in Nursing
Approved by: GTER G, GAID, PhD, MAN, RN (Print Name and Signature) Dean, PRC I.D. No.:0302269 Valid Until: September 13, 2015 Date document is signed: Time: ____________________ Please specify Highest Nursing Degree Earned: Master of Arts in Nursing
ACTUAL DELIVERY in: Adventist Medical Center, Barangay San Miguel, Iligan City Gregorio T. Lluch Memorial Hospital, Palao, Iligan City Hospital/Home/Lying-in, Municipality/City/Province Prepared by: Printed name and Signature of Student: CRISTINA L. JAYSON Patients INITIAL Only Case Number (not applicable for Birthing/Lying-in Clinics/Homes) ND 203287 Normal Spontaneous Vaginal Delivery
Type of Delivery
D. R. Nurse on Duty (Name and Signature) (If Midwife on Duty, Signature Not Required)
Dyan Marie L. Villaver, RN PRC Number: 0411677 Valid Until: November 1, 2015 Cheryl S. Epe, RN PRC Number: 0318137 Valid Until: September 10, 2016 Merlita B. Omlero, RM PRC Number: 0101442 Valid Until: June 5, 2015
Lucy May L. Bucayan, MN, RN PRC Number: 0193232 Valid Until: May 25, 2016 Daverly M. Caeda, MN, RN PRC Number: 0364265 Valid Until: April 28, 2016 Daverly M. Caeda, MN, RN PRC Number: 0364265 Valid Until: April 28, 2016
EG 154393
JT 79256
Noted by: EVALYN M. LECCIONES, MN, RN (Print Name and Signature) Clinical Coordinator, PRC I.D No.: 0245303 Valid Until:May 9, 2015 Date document is signed: ________ Time:______________ Please specify Highest Nursing Degree Earned: Master in Nursing
Approved by: GTER G, GAID, PhD, MAN, RN (Print Name and Signature) Dean, PRC I.D. No.:0302269 Valid Until: September 13, 2015 Date document is signed: Time: ____________________ Please specify Highest Nursing Degree Earned: Master of Arts in Nursing
RB 147899
Appendectomy
Jed R. Santos, RN, CRN PRC Number: 0660385 Valid Until: July 14, 2016 Wendy Mar S. Rodrigo, RN PRC Number: 0313886 Valid Until: March 3, 2015
Darilyn G. Literatus, MN, RN PRC Number: 0301632 Valid Until: November 25, 2016 Sheilma Dreamy G. Manata, MN,RN PRC Number: 0173264 Valid Until: May 28, 2017
SB 130179
Pelvic Laparotomy
JG 062232
Belen Joy C. Patindol, RN PRC Number: 0306764 Valid Until: December 20, 2015
Sheilma Dreamy G. Manata,MN, RN PRC Number: 0173264 Valid Until: May 28, 2017
Noted by: EVALYN M. LECCIONES, MN, RN (Print Name and Signature) Clinical Coordinator, PRC I.D No.: 0245303 Valid Until:May 9, 2015 Date document is signed: ________ Time:______________ Please specify Highest Nursing Degree Earned: Master in Nursing
Approved by: GTER G, GAID, PhD, MAN, RN (Print Name and Signature) Dean, PRC I.D. No.:0302269 Valid Until: September 13, 2015 Date document is signed: Time: ____________________ Please specify Highest Nursing Degree Earned: Master of Arts in Nursing
PROCEDURE PERFORMED
RB 148071
Deardrie Rofany P. Dumadag, RN PRC Number: 0582588 Valid Until: July 15, 2015
Darilyn G. Literatus, MN, RN PRC Number: 0301632 Valid Until: November 25, 2016
RV 157535
Open Cholecystectomy with Intraoperative Cholangiogram, Common Bile Duct Exploration, Ttube Cholangiogram, Choledochodudenostomy Drain Herniorrhaphy with Right Lichenstein Mesh
Belen Joy C. Patindol, RN PRC Number: 0306764 Valid Until: December 20, 2015
Sheilma Dreamy G. Manata, MN, RN PRC Number: 0173264 Valid Until: May 28, 2017
RE 173629
Jan Michael B. Labuga,MN, RN PRC Number: 0390113 Valid Until: January 9, 2015
Darilyn G. Literatus, MN, RN PRC Number: 0301632 Valid Until: November 25, 2016
Noted by: EVALYN M. LECCIONES, MN, RN (Print Name and Signature) Clinical Coordinator, PRC I.D No.: 0245303 Valid Until:May 9, 2015 Date document is signed: ________ Time:______________ Please specify Highest Nursing Degree Earned: Master in Nursing
Approved by: GTER G, GAID, PhD, MAN, RN (Print Name and Signature) Dean, PRC I.D. No.:0302269 Valid Until: September 13, 2015 Date document is signed: Time: ____________________ Please specify Highest Nursing Degree Earned: Master of Arts in Nursing