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Republic of the Philippines

PALAWAN STATE UNIVERSITY


College of Nursing and Health Sciences
Tiniguiban Heights, Puerto Princesa City
Registrar (048) 433-7583 • Dean (+6348) 434-9730
Fax No. (048) 433-5303 • www.psu-online.edu.ph
Email: cnhs.psu72@gmail.com • cnhs.psu72@yahoo.com

Name of Student: _______________________ REINA M. CAÑEDO_______


Accreditation Level (if any): N/A Year Granted: N/A
Date school/program was recognized: FEBRUARY 20, 2007_____ Number: 001 Year:
2007
First Course (if any): N/A School Graduated From: N/A Year: N/A
Year of admission in the BSN Program: 2003 Year graduated from the BSN Program: 2009

I. MAJOR SCRUBS
Signa
Type of ture
N Date of Case Name of Operation Name of Name of
Diagnosis Anesth Name of Surgeon of OR
o. Operation No. Patient Performed Hospital OR Scrub Nurse
esia Scrub
Nurse
February 11, 17949 Arsenio R. ABOVE knee Voltaire T. Ledesma, Ospital Ng Yvonne M. Lucero,
1 Burn 3rd Degree Spinal
2008 2 Parangue Amputation MD Palawan RN, MAN
00933 Anna Marie M. G2P1, Previous Cesarean Ospital Ng
2 April 17, 2008
1 Jimenez Section
Elective Cesarean Section Spinal Lorna B.Felizarte, MD Palawan
Marlina M, Flores, RN

January 08, 17796 Gloria B. “Elective Cesarean Ospital Ng Yvonne M. Lucero,


3 CS (x) 2 TO CDP G1P1 Spinal Humbelina Harriet M. Lazo,MD
2008 1 Esteban Section Palawan RN, MAN

December 29, 19646 Ospital Ng Yvonne M. Lucero,


4 Vida B. Ostria Acute Appendicitis Appendectomy Spinal Metodio R. Lazo, MD
2008 4 Palawan RN, MAN

18403 Acute Ospital Ng


5 May 10, 2008 Fely R. Azucena Appendectomy Spinal Ricky V. Torres, MD Marlina M, Flores, RN
2 Appendicitis,gangrenous Palawan

N
Supervised by Signature Date Signed Degree PRC No Valid Until PNA No. Valid Until
o.
1 Sonia D. Ygloria, RN Master of Arts in Nursing
2 Sonia D. Ygloria, RN Master of Arts in Nursing
3 Sonia D. Ygloria, RN Master of Arts in Nursing
4 Hilda S. Carlos, RN Master of Arts in Nursing 0288015 February 25, 2012 116396 December 31, 2009
5 Hilda S. Carlos, RN Master of Arts in Nursing 0288015 February 25, 2012 116396 December 31, 2009

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

REINA M. CAÑEDO MARY JOY A. HABARADAS, RN, MAN AGNES B. PALAO, RN, MAN, Ph.D MICHAEL ANGELO GIN D.
MACOLOR, RM, RN, MAN
Name of Student Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse
Signature over Printed Name of Dean
Republic of the Philippines
PALAWAN STATE UNIVERSITY
College of Nursing and Health Sciences
Tiniguiban Heights, Puerto Princesa City
Registrar (048) 433-7583 • Dean (+6348) 434-9730
Fax No. (048) 433-5303 • www.psu-online.edu.ph
Email: cnhs.psu72@gmail.com • cnhs.psu72@yahoo.com

Date Signed: ________________ Date Signed: ______________ Date Signed:


________________
Degree: Master of Arts in Nursing Degree: Doctor of Philosophy Degree: Master of
Arts in Nursing
a) PRC No: 0200857 Valid Until: July 7, 2010 a.) PRC No: 0058955 Valid Until: October 4,2009 a.)
PRC No: 0355629 Valid Until: June 25, 2010
b) PNA No: 116394 Valid Until: December 31, 2009 b.) PNA No: 12564 Valid Until: Lifetime
b.) PNA No: 116395 Valid Until: December 31, 2009
c.) ANSAP No: 0296 Valid Until: Lifetime c.) ADPCN No: 0800
Valid Until: December 31, 2009
d.) RM PRC No: 0134034 Valid Until: June
25, 2010

Name of Student: _______________________ REINA M. CAÑEDO______


Accreditation Level (if any): N/A Year Granted: N/A
Date school/program was recognized: FEBRUARY 20, 2007_____ Number: 001 Year:
2007
First Course (if any): N/A School Graduated From: N/A Year: N/A
Year of admission in the BSN Program: 2003 Year graduated from the BSN Program: 2009

Il. MINOR SCRUBS


Signat
Type of ure of
N Date of Case Name of Operation Name of Name of
Diagnosis Anesth Name of Surgeon OR
o. Operation No. Patient Performed Hospital OR Scrub Nurse
esia Scrub
Nurse
February 18, 1795 Ospital Ng Yvonne M. Lucero,
1 Danilo S. Dagot T/C Septic Arthrites Open Arthrectomy Local Voltaire T. Ledesma, MD RN, MAN
2008 97 Palawan
Hemorrhoids With
January 16, 1975 Hemorrohoidectom Reynaldo Frederick N. Ospital Ng Yvonne M. Lucero,
2 Vic A. Lagera Internal And External Local
RN, MAN
2009 44 y Quicho,MD Palawan
Compound
March 16, 2004 Francis B. Lacerated wound Ospital Ng Yvonne M. Lucero,
3 Suturing Local Maribeth N. Javarez, MD
2009 77 Baldosano 2cm Right Foot Palawan RN, MAN
November 22, 1168 Ospital Ng Nilda N. Tamalayan,
4 Dexter Z. Santos Local Metodio R. Lazo, MD
RN
2008 42 Palawan
March 09, 2005 Ospital Ng Yvonne M. Lucero,
5 Cleft Palate Suturing Local
2009 09 Palawan RN, MAN

N
Supervised by Signature Date Signed Degree PRC No Valid Until PNA No. Valid Until
o.
Republic of the Philippines
PALAWAN STATE UNIVERSITY
College of Nursing and Health Sciences
Tiniguiban Heights, Puerto Princesa City
Registrar (048) 433-7583 • Dean (+6348) 434-9730
Fax No. (048) 433-5303 • www.psu-online.edu.ph
Email: cnhs.psu72@gmail.com • cnhs.psu72@yahoo.com

Master of Arts in
1 Hilda S. Carlos, RN 0288015 February 25, 2012 116396 December 31, 2009
Nursing
Master of Arts in 0288015
2 Hilda S. Carlos, RN February 25, 2012 116396 December 31, 2009
Nursing
Master of Arts in 0288015
3 Hilda S. Carlos, RN February 25, 2012 116396 December 31, 2009
Nursing
Master of Arts in
4 Hilda S. Carlos, RN 0288015 February 25, 2012 116396 December 31, 2009
Nursing
Master of Arts in 0288015
5 Hilda S. Carlos, RN February 25, 2012 116396 December 31, 2009
Nursing

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

REINA M. CAÑEDO MARY JOY A. HABARADAS, RN, MAN AGNES B. PALAO, RN, MAN, Ph.D MICHAEL ANGELO GIN D.
MACOLOR, RM, RN, MAN
Name of Student Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse
Signature over Printed Name of Dean
Date Signed: ________________ Date Signed: ______________ Date Signed:
________________
Degree: Master of Arts in Nursing Degree: Doctor of Philosophy Degree: Master of
Arts in Nursing
a) PRC No: 0200857 Valid Until: July 7, 2010 a.) PRC No: 0058955 Valid Until: October 4,2009 a.) PRC
No: 0355629 Valid Until: June 25, 2010
b) PNA No: 116394 Valid Until: December 31, 2009 b.) PNA No: 12564 Valid Until: Lifetime
b.) PNA No: 116395 Valid Until: December 31, 2009
c.) ANSAP No: 0296 Valid Until: Lifetime c.) ADPCN No: 0800
Valid Until: December 31, 2009
d.) RM PRC No: 0134034 Valid Until: June
25, 2010

Name of Student: ________________________ REINA M. CAÑEDO______


Accreditation Level (if any): N/A Year Granted: N/A
Date school/program was recognized: FEBRUARY 20, 2007_____ Number: 001 Year:
2007
First Course (if any): N/A School Graduated From: N/A Year: N/A
Year of admission in the BSN Program: 2003 Year graduated from the BSN Program: 2009

III. ACTUAL DELIVERIES


Republic of the Philippines
PALAWAN STATE UNIVERSITY
College of Nursing and Health Sciences
Tiniguiban Heights, Puerto Princesa City
Registrar (048) 433-7583 • Dean (+6348) 434-9730
Fax No. (048) 433-5303 • www.psu-online.edu.ph
Email: cnhs.psu72@gmail.com • cnhs.psu72@yahoo.com

N Case Name of Age Date of Time of Gender of Name of Type of


Diagnosis
o. No. Mother (y/o) Delivery Delivery Baby Hospital Delivery
08245 Pregnancy Uterine Full Term, G5P5, Marissa d. Delos September 15, Ospital Ng
1 2 Delivered Cephalic Santos
36
2007
9:01AM Male
Palawan
NSVD
18242 Pregnancy Uterine Full Term, G2P1, Ospital Ng
2 3 Delivered Cephalic
Irene F. Silvestre 20 April 11, 2009 7:15AM female
Palawan
NSVD
18529 Pregnancy Uterine Full Term, G1P1, Ospital Ng
3 6 Delivered Cephalic
Charo G. Gailogo 24 May 31, 2008 12:13PM Female
Palawan
NSVD
19714 Pregnancy Uterine 36 Weeks AOG by LMP, January 08, Ospital Ng Breech
4 3 Breech in Labor
Leah A. Daganta 20
2009
9:59AM Male
Palawan Presentation
19725 Pregnancy Uterine Full Term, G3P2, January 11, Ospital Ng
5 1 Delivered Cephalic
Grace G. fredilez 32
2009
9:17AM Female
Palawan
NSVD
* Normal Spontaneous Vaginal Delivery

N
Supervised by Signature Date Signed Degree PRC No Valid Until PNA No. Valid Until
o.
1 Sonia D. Ygloria RN Master of Arts in Nursing
Marvin Pulao,
2 Master of Arts in Nursing
RM,RN,MAN
3 Sonia D. Ygloria RN Master of Arts in Nursing
Marvin Pulao,
4 Master of Arts in Nursing
RM,RN,MAN
5 Hilda S. Carlos, RN Master of Arts in Nursing 0288015 February 25, 2012 116396

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

REINA M. CAÑEDO MARY JOY A. HABARADAS, RN, MAN AGNES B. PALAO, RN, MAN, Ph.D MICHAEL ANGELO GIN D.
MACOLOR, RM, RN, MAN
Name of Student Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse
Signature over Printed Name of Dean
Date Signed: ________________ Date Signed: ______________ Date Signed:
________________
Degree: Master of Arts in Nursing Degree: Doctor of Philosophy Degree: Master of
Arts in Nursing
a) PRC No: 0200857 Valid Until: July 7, 2010 a.) PRC No: 0058955 Valid Until: October 4,2009 a.) PRC
No: 0355629 Valid Until: June 25, 2010
b) PNA No: 116394 Valid Until: December 31, 2009 b.) PNA No: 12564 Valid Until: Lifetime
b.) PNA No: 116395 Valid Until: December 31, 2009
Republic of the Philippines
PALAWAN STATE UNIVERSITY
College of Nursing and Health Sciences
Tiniguiban Heights, Puerto Princesa City
Registrar (048) 433-7583 • Dean (+6348) 434-9730
Fax No. (048) 433-5303 • www.psu-online.edu.ph
Email: cnhs.psu72@gmail.com • cnhs.psu72@yahoo.com

c.) ANSAP No: 0296 Valid Until: Lifetime c.) ADPCN No: 0800
Valid Until: December 31, 2009
d.) RM PRC No: 0134034 Valid Until: June
25, 2010

Name of Student: ________________________ REINA M. CAÑEDO_______


Accreditation Level (if any): N/A Year Granted: N/A
Date school/program was recognized: FEBRUARY 20, 2007_____ Number: 001 Year:
2007
First Course (if any): N/A School Graduated From: N/A Year: N/A
Year of admission in the BSN Program: 2003 Year graduated from the BSN Program: 2009

IV. DELIVERIES ASSISTED


Type
No Case Age Date of Time of Gender of Name of of
Diagnosis Name of Mother
. No. (y/o) Delivery Delivery Baby Hospital Delive
ry
Pregnancy Uterine Full Term, G1P1, Delivered Jackqueline B. January 07, Ospital Ng
1 029481 17 7:54PM Female NSVD
Cephalic Pasadina 2008 Palawan
Pregnancy Uterine Full Term, G1P1, Delivered Ospital Ng
2 085386 Maricel S. Tan 18 June 04, 2008 7:49PM Female NSVD
Cephalic Palawan
Pregnancy Uterine Full Term, G1P1, Delivered December 24, Ospital Ng
3 196361 Evina G. Daquinotqn 23 2:25PM Female NSVD
Cephalic 2008 Palawan
Pregnancy Uterine Full Term, G3P2, Delivered January 17, Ospital Ng
4 138533 Agnes A. Jose 21 1:40PM Male NSVD
Cephalic 2008 Palawan
Pregnancy Uterine Full Term, G2P1, Delivered January 11, Ospital Ng
5 127482 Carla C. Pilapil 23 9:45AM Male NSVD
Cephalic 2008 Palawan
* Normal Spontaneous Vaginal Delivery

No
Supervised by Signature Date Signed Degree PRC No Valid Until PNA No. Valid Until
.
Marvin Pulao, Master of Arts in
1
RM,RN,MAN Nursing
Master of Arts in
2 Hilda S. Carlos, RN 0288015 February 25, 2012 116396 December 31, 2009
Nursing
Master of Arts in
3 Hilda S. Carlos, RN 0288015 February 25, 2012 116396 December 31, 2009
Nursing
Master of Arts in
4 Hilda S. Carlos, RN 0288015 February 25, 2012 116396 December 31, 2009
Nursing
5 Hilda S. Carlos, RN Master of Arts in 0288015 February 25, 2012 116396 December 31, 2009
Republic of the Philippines
PALAWAN STATE UNIVERSITY
College of Nursing and Health Sciences
Tiniguiban Heights, Puerto Princesa City
Registrar (048) 433-7583 • Dean (+6348) 434-9730
Fax No. (048) 433-5303 • www.psu-online.edu.ph
Email: cnhs.psu72@gmail.com • cnhs.psu72@yahoo.com

Nursing

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

REINA M. CAÑEDO MARY JOY A. HABARADAS, RN, MAN AGNES B. PALAO, RN, MAN, Ph.D
MICHAEL ANGELO GIN D. MACOLOR, RM, RN, MAN
Name of Student Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse Signature
over Printed Name of Dean
Date Signed: ________________ Date Signed: ______________ Date Signed:
________________
Degree: Master of Arts in Nursing Degree: Doctor of Philosophy Degree: Master of
Arts in Nursing
a) PRC No: 0200857 Valid Until: July 7, 2010 a.) PRC No: 0058955 Valid Until: October 4,2009 a.)
PRC No: 0355629 Valid Until: June 25, 2010
b) PNA No: 116394 Valid Until: December 31, 2009 b.) PNA No: 12564 Valid Until: Lifetime
b.) PNA No: 116395 Valid Until: December 31, 2009
c.) ANSAP No: 0296 Valid Until: Lifetime c.) ADPCN No: 0800
Valid Until: December 31, 2009
d.) RM PRC No: 0134034 Valid Until: June
25, 2010

Name of Student: _________________________ REINA M. CAÑEDO______


Accreditation Level (if any): N/A Year Granted: N/A
Date school/program was recognized: FEBRUARY 20, 2007____ Number: 001 Year:
2007
First Course (if any): N/A School Graduated From: N/A Year: N/A
Year of admission in the BSN Program: 2003 Year graduated from the BSN Program: 2009

V. CORD DRESSING
No Case
Date Performed Name of Baby Gender of Baby Name of Mother Age (y/o) Name of Hospital
. No.
1 183073 October 4, 2008 Baby Girl Caras Female Marlyn S. Caras 23 Ospital Ng Palawan
2 176919 December 18, 2007 Baby Boy Villanueva Male Emily R. Villanueva 37 Ospital Ng Palawan
Kathleen Magdalene G.
3 115039 April 11, 2008 Baby Girl Javier Female 20 Ospital Ng Palawan
Javier
4 118620 April 11, 2008 Baby Boy Tumbaga Male Maylene V. Tumbaga 27 Ospital Ng Palawan
5 185385 June 03, 2008 Baby Girl Tundal Female Ellen A. Tundal 37 Ospital Ng Palawan
Republic of the Philippines
PALAWAN STATE UNIVERSITY
College of Nursing and Health Sciences
Tiniguiban Heights, Puerto Princesa City
Registrar (048) 433-7583 • Dean (+6348) 434-9730
Fax No. (048) 433-5303 • www.psu-online.edu.ph
Email: cnhs.psu72@gmail.com • cnhs.psu72@yahoo.com

N
Supervised by Signature Date Signed Degree PRC No Valid Until PNA No. Valid Until
o.
Marvin Pulao, Master of Arts in
1
RM,RN,MAN Nursing
Marvin Pulao, Master of Arts in
2
RM,RN,MAN Nursing
Marvin Pulao, Master of Arts in
3
RM,RN,MAN Nursing
Marvin Pulao, Master of Arts in
4
RM,RN,MAN Nursing
Marvin Pulao, Master of Arts in
5
RM,RN,MAN Nursing

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

REINA M. CAÑEDO MARY JOY A. HABARADAS, RN, MAN AGNES B. PALAO, RN, MAN, Ph.D MICHAEL ANGELO GIN D.
MACOLOR, RM, RN, MAN
Name of Student Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse Signature
over Printed Name of Dean
Date Signed: ________________ Date Signed: ______________ Date Signed:
________________
Degree: Master of Arts in Nursing Degree: Doctor of Philosophy Degree: Master of
Arts in Nursing
a) PRC No: 0200857 Valid Until: July 7, 2010 a.) PRC No: 0058955 Valid Until: October 4,2009 a.)
PRC No: 0355629 Valid Until: June 25, 2010
b) PNA No: 116394 Valid Until: December 31, 2009 b.) PNA No: 12564 Valid Until: Lifetime
b.) PNA No: 116395 Valid Until: December 31, 2009
c.) ANSAP No: 0296 Valid Until: Lifetime c.) ADPCN No: 0800
Valid Until: December 31, 2009