Doa Remedios

Trinidad Romualdez Medical Foundation

Calanipawan Road,
Calanipawan, Tacloban City 6500 Philippines
Tel. Nos.(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/ 327-5004, E-mail
address: rtr1980@yahoo.com
SURGICAL SCRUB in EASTERN VISAYAS REGIONAL MEDICAL CENTER,
Tacloban City, Leyte
Prepared by: RALPH SAUL M. MONTESCLAROS
DATE PERFORMED AND
TIME STARTED

PATIENTS INITIALS
(ONLY)
CASE NUMBER

SURGICAL PROCEDURE

O.R. NURSE ON DUTY

(NAME AND SIGNATURE)

SUPERVISED BY CLINICAL
INSTRUCTOR
(NAME AND SIGNATURE)

November 26, 2012

Time started: 01:00PM

C.C.
59-21-88

Open Reduction Internal

Fixation with Interosseus
Wire of Mandibular
Fracture, Repair of
Lacerations

HELEN D. DEBUTON, R.N.

LOURADEL M. ULBATA, M.AN.,

R.N.

August 12, 2013

Time started: 03:37PM

B.E.
62-63-50

Emergency
Appendectomy

RICHARD NORIEL D. TOMAUB,

R.N.

LOURADEL M. ULBATA,
M.A.N., R.N.

Noted by: MRS. JESUSA M. MAGNO, M.A.N., R.N.

GASCO, D.M., HRM, M.N., R.N.
Clinical Coordinator
PRC I.D No.0136071 Valid Until: December 2017
PNA No.14275
Valid Until: Life member

Approved by:

DR. SOCORRO SALVACION

Dean, College of Nursing

PRC I.D No. 0063136 Valid Until: June 2016
PNA No. 01219 Valid Until: Life member

Date document is signed: ___________Time___________

Highest Nursing Degree Earned: Master of Arts in Nursing
___________Time___________

ADPCN No. 11-192 Valid Until: June 2015

Date document is signed:
Highest Nursing Degree Earned:

Doctor of Management
SUBSCRIBED AND SWORN to before me this ________________________ at Tacloban City by the above parties who presented their
competence evidence of identities.

Doa Remedios Trinidad

Romualdez Medical Foundation

Calanipawan Road, Calanipawan, Tacloban City

6500 Philippines
Tel. Nos.(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/ 327-5004, E-mail
address: rtr1980@yahoo.com
SURGICAL SCRUB in EASTERN VISAYAS REGIONAL MEDICAL CENTER, Tacloban City, Leyte

Prepared by: RALPH SAUL M. MONTESCLAROS

DATE PERFORMED AND
TIME STARTED

PATIENTS INITIALS
(ONLY)
CASE NUMBER

SURGICAL PROCEDURE

O.R. NURSE ON DUTY

(NAME AND SIGNATURE)

SUPERVISED BY CLINICAL
INSTRUCTOR
(NAME AND SIGNATURE)

February 23,2014
Time Stared: 01:54PM

L.V.
60-29-62

Emergency Primary Lower

Segment Transverse
Caesarean Section

RICHARD NORIEL D.
TOMAUB, R.N.

LOURADEL M. ULBATA, M.A.N.,

R.N.

Noted by: MRS. JESUSA M. MAGNO, M.A.N., R.N.

GASCO, D.M., HRM, M.N., R.N.
Clinical Coordinator
PRC I.D No.0136071 Valid Until: December 2017
PNA No.14275
Valid Until: Life member
Date document is signed: ___________Time___________
Highest Nursing Degree Earned: Master of Arts in Nursing
___________Time___________

Approved by:

DR. SOCORRO SALVACION

Dean, College of Nursing

PRC I.D No. 0063136 Valid Until: June 2016
PNA No. 01219 Valid Until: Life member
ADPCN No. 11-192 Valid Until: June 2015
Date document is signed:
Highest Nursing Degree Earned:

Doctor of Management
SUBSCRIBED AND SWORN to before me this ________________________ at Tacloban City by the above parties who presented their
competence evidence of identities.

Doa Remedios Trinidad

Romualdez Medical Foundation

Calanipawan Road, Calanipawan, Tacloban City 6500

Philippines
Tel. Nos.(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/ 327-5004, E-mail
address: rtr1980@yahoo.com
MAJOR CIRCULATING in EASTERN VISAYAS REGIONAL MEDICAL CENTER, Tacloban City, Leyte
Prepared by: RALPH SAUL M. MONTESCLAROS
DATE PERFORMED AND
TIME STARTED

PATIENTS INITIALS
(ONLY)
CASE NUMBER

SURGICAL PROCEDURE

O.R. NURSE ON DUTY

(NAME AND SIGNATURE)

SUPERVISED BY CLINICAL
INSTRUCTOR
(NAME AND SIGNATURE)

August 12, 2013

Time Started: 09:56AM

J.T.
61-87-60

Elective Exploratory
Laparotomy, SalpingoOophorectomy, Left

HELEN D. DEBUTON, R.N.

LOURADEL M. ULBATA,
M.A.N., R.N.

April 9, 2014
Time Started: 05:33PM

G.B.
65-13-65

Emergency Repeat Lower

Segment Transverse
Caesarean Section

Noted by: MRS. JESUSA M. MAGNO, M.A.N., R.N.

GASCO, D.M., HRM, M.N., R.N.
Clinical Coordinator
PRC I.D No.0136071 Valid Until: December 2017
PNA No.14275
Valid Until: Life member
Date document is signed: ___________Time___________
Highest Nursing Degree Earned: Master of Arts in Nursing
___________Time___________

ANGELA BIANCA Q. LADRERA,

R.N.

Approved by:

LOURADEL M. ULBATA,
M.A.N., R.N.

DR. SOCORRO SALVACION

Dean, College of Nursing

PRC I.D No. 0063136 Valid Until: June 2016
PNA No. 01219 Valid Until: Life member
ADPCN No. 11-192 Valid Until: June 2015
Date document is signed:
Highest Nursing Degree Earned:

Doctor of Management
SUBSCRIBED AND SWORN to before me this ________________________ at Tacloban City by the above parties who presented their
competence evidence of identities.

Doa Remedios Trinidad

Romualdez Medical Foundation

Calanipawan Road, Calanipawan, Tacloban City 6500

Philippines
Tel. Nos.(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/ 327-5004, E-mail
address: rtr1980@yahoo.com
MAJOR CIRCULATING in EASTERN VISAYAS REGIONAL MEDICAL CENTER, Tacloban City, Leyte

Prepared by: RALPH SAUL M. MONTESCLAROS

DATE PERFORMED AND

TIME STARTED

PATIENTS INITIALS
(ONLY)
CASE NUMBER

SURGICAL PROCEDURE

O.R. NURSE ON DUTY

(NAME AND SIGNATURE)

SUPERVISED BY CLINICAL
INSTRUCTOR
(NAME AND SIGNATURE)

May 7,2014
Time started: 07:40AM

T.A.
66-53-14

Emergency Saucerization

EVELINA S. LIMOS, M.A.N.,

R.N.

LOURADEL M. ULBATA, M.A.N.,

R.N.

Noted by: MRS. JESUSA M. MAGNO, M.A.N., R.N.

GASCO, D.M., HRM, M.N., R.N.
Clinical Coordinator
PRC I.D No.0136071 Valid Until: December 2017
PNA No.14275
Valid Until: Life member
Date document is signed: ___________Time___________
Highest Nursing Degree Earned: Master of Arts in Nursing
___________Time___________

Approved by:

DR. SOCORRO SALVACION

Dean, College of Nursing

PRC I.D No. 0063136 Valid Until: June 2016
PNA No. 01219 Valid Until: Life member
ADPCN No. 11-192 Valid Until: June 2015
Date document is signed:
Highest Nursing Degree Earned:

Doctor of Management
SUBSCRIBED AND SWORN to before me this ________________________ at Tacloban City by the above parties who presented their
competence evidence of identities.

Doa Remedios Trinidad

Romualdez Medical Foundation
Calanipawan Road, Calanipawan, Tacloban City 6500
Philippines
Tel. Nos.(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/ 327-5004, E-mail
address: rtr1980@yahoo.com

MAJOR CIRCULATING in REMEDIOS TRINIDAD ROMUALDEZ HOSPITAL, Tacloban

City, Leyte
Prepared by: RALPH SAUL M. MONTESCLAROS
DATE PERFORMED AND
TIME STARTED

PATIENTS INITIALS
(ONLY)
CASE NUMBER

SURGICAL PROCEDURE

O.R. NURSE ON DUTY

(NAME AND SIGNATURE)

SUPERVISED BY CLINICAL
INSTRUCTOR
(NAME AND SIGNATURE)

May 22,2014
Time started: 10:19AM

E.E.
05-14-78

Open Reduction Internal

Fixation (Plates and
Screws), Left Clavicle

RHAY CHRISTIAN M.
AUSTERO, R.N.

ASELA C. CELESTIAL, M.A.N.,

R.N., R.M.

Noted by: MRS. JESUSA M. MAGNO, M.A.N., R.N.

GASCO, D.M., HRM, M.N., R.N.
Clinical Coordinator
PRC I.D No.0136071 Valid Until: December 2017
PNA No.14275
Valid Until: Life member
Date document is signed: ___________Time___________
Highest Nursing Degree Earned: Master of Arts in Nursing
___________Time___________

Approved by:

DR. SOCORRO SALVACION

Dean, College of Nursing

PRC I.D No. 0063136 Valid Until: June 2016
PNA No. 01219 Valid Until: Life member
ADPCN No. 11-192 Valid Until: June 2015
Date document is signed:
Highest Nursing Degree Earned:

Doctor of Management
SUBSCRIBED AND SWORN to before me this ________________________ at Tacloban City by the above parties who presented their
competence evidence of identities.

Doa Remedios Trinidad Romualdez

Medical Foundation

Tel. Nos.(053) 321-2345/

rtr1980@yahoo.com

321-4150/

Calanipawan Road, Calanipawan, Tacloban City 6500 Philippines

325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/

327-5004,

E-mail

address:

NEWBORN CARE in ABUYOG DISTRICT HOSPITAL, Abuyog,

Leyte

Prepared by: RALPH SAUL M. MONTESCLAROS

DATE PERFORMED AND

TIME STARTED

PATIENTS INITIALS
(ONLY)
CASE NUMBER

PROCEDURE
PERFORMED

NICU NURSE ON DUTY

(NAME AND SIGNATURE)

SUPERVISED BY CLINICAL
INSTRUCTOR
(NAME AND SIGNATURE)

January 29, 2012

Time of Delivery:
06:39AM

Baby Boy A.
62-14-15

Immediate Care of the

Newborn

RACHEL S. HINUNANGAN, R.N.

LOURADEL M. ULBATA,
M.A.N., R.N.

Noted by: MRS. JESUSA M. MAGNO, M.A.N., R.N.

GASCO, D.M., HRM, M.N., R.N.
Clinical Coordinator
PRC I.D No.0136071 Valid Until: December 2017
PNA No.14275
Valid Until: Life member
Date document is signed: ___________Time___________
Highest Nursing Degree Earned: Master of Arts in Nursing
___________Time___________

Approved by:

DR. SOCORRO SALVACION

Dean, College of Nursing

PRC I.D No. 0063136 Valid Until: June 2016
PNA No. 01219 Valid Until: Life member
ADPCN No. 11-192 Valid Until: June 2015
Date document is signed:

Highest Nursing Degree Earned:

Doctor of Management
SUBSCRIBED AND SWORN to before me this ________________________ at Tacloban City by the above parties who presented their
competence evidence of identities.

Doa Remedios Trinidad Romualdez

Medical Foundation

Calanipawan Road, Calanipawan, Tacloban City 6500

Philippines
Tel. Nos.(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/ 327-5004, E-mail
address: rtr1980@yahoo.com
ASSISTED DELIVERY in EASTERN VISAYAS REGIONAL MEDICAL CENTER,
Tacloban City, Leyte
Prepared by: RALPH SAUL M. MONTESCLAROS
DATE PERFORMED AND
TIME STARTED

PATIENTS INITIALS
(ONLY)
CASE NUMBER

PROCEDURE
PERFORMED

D.R. NURSE ON DUTY

(NAME AND SIGNATURE)

SUPERVISED BY CLINICAL
INSTRUCTOR
(NAME AND SIGNATURE)

May 19,2013
Time of Delivery:
06:40AM

J.D.
39-45-85

Assisted Delivery

JANICE C. GO, M.A.N., R.N.

REBECCA B. DE ASIS, M.A.N.,

R.N.

June 3,2013
Time of Delivery:
12:01AM

L.B.
61-71-90

Assisted Delivery

PAMELA LYNN G. CATILOGO,

M.M., R.N.

REBECCA B. DE ASIS, M.A.N.,

R.N.

Noted by: MRS. JESUSA M. MAGNO, M.A.N., R.N.

GASCO, D.M., HRM, M.N., R.N.
Clinical Coordinator
PRC I.D No.0136071 Valid Until: December 2017
PNA No.14275
Valid Until: Life member
Date document is signed: ___________Time___________
Highest Nursing Degree Earned: Master of Arts in Nursing
___________Time___________

Approved by:

DR. SOCORRO SALVACION

Dean, College of Nursing

PRC I.D No. 0063136 Valid Until: June 2016
PNA No. 01219 Valid Until: Life member
ADPCN No. 11-192 Valid Until: June 2015
Date document is signed:
Highest Nursing Degree Earned:

Doctor of Management
SUBSCRIBED AND SWORN to before me this ________________________ at Tacloban City by the above parties who presented their
competence evidence of identities.

DOA REMEDIOS TRINIDAD

ROMUALDEZ MEDICAL FOUNDATION

Calanipawan Road, Calanipawan, Tacloban City 6500

Philippines
Tel. Nos.(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/ 327-5004, E-mail
address: rtr1980@yahoo.com
ASSISTED DELIVERY in EASTERN VISAYAS REGIONAL MEDICAL CENTER,
Tacloban City, Leyte
Prepared by: RALPH SAUL M. MONTESCLAROS
DATE PERFORMED AND
TIME STARTED

PATIENTS INITIALS
(ONLY)
CASE NUMBER

PROCEDURE
PERFORMED

D.R. NURSE ON DUTY

(NAME AND SIGNATURE)

SUPERVISED BY CLINICAL
INSTRUCTOR
(NAME AND SIGNATURE)

September 8,2013
Time of Delivery:
10:04AM

M.H.
63-94-56

Assisted Delivery

REBECCA M. GORRES, R.N., R.M.

EVELYN U. RANCES, M.H.S.,

R.N.

May 13,2014
Time of Delivery:
01:55PM

R.J.
66-56-77

Assisted Delivery

ALONA V. GROTHE, R.N.

EVELYN U. RANCES, M.H.S.,

R.N.

Noted by: MRS. JESUSA M. MAGNO, M.A.N., R.N.

GASCO, D.M., HRM, M.N., R.N.
Clinical Coordinator
PRC I.D No.0136071 Valid Until: December 2017
PNA No.14275
Valid Until: Life member
Date document is signed: ___________Time___________
Highest Nursing Degree Earned: Master of Arts in Nursing
___________Time___________

Approved by:

DR. SOCORRO SALVACION

Dean, College of Nursing

PRC I.D No. 0063136 Valid Until: June 2016
PNA No. 01219 Valid Until: Life member
ADPCN No. 11-192 Valid Until: June 2015
Date document is signed:
Highest Nursing Degree Earned:

Doctor of Management
SUBSCRIBED AND SWORN to before me this ________________________ at Tacloban City by the above parties who
presented their competence evidence of identities.

Doa Remedios Trinidad Romualdez Medical

Foundation

Calanipawan Road, Calanipawan, Tacloban City 6500

Philippines
Tel. Nos.(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/
327-5004, E-mail address: rtr1980@yahoo.com
ACTUAL DELIVERY HANDLED in EASTERN VISAYAS REGIONAL MEDICAL CENTER, Tacloban City, Leyte
Prepared by: RALPH SAUL M. MONTESCLAROS
DATE PERFORMED AND
TIME STARTED

PATIENTS INITIALS
(ONLY)

PROCEDURE
PERFORMED

D.R. NURSE ON DUTY

(NAME AND SIGNATURE)

SUPERVISED BY CLINICAL
INSTRUCTOR

CASE NUMBER

July 29, 2012

Time of Delivery :
05:45PM

C.B.
56-15-03

May 20, 2013

Time of Delivery:
11:46AM
October 27,2013
Time of Delivery:
01:09PM

(NAME AND SIGNATURE)

Handled Delivery

MA. VILMA M. ALMADEN,

R.N.

REBECCA B. DE ASIS,
M.A.N., R.N.

K.S.
61-50-82

Handled Delivery

PAMELA LYNN G. CATILOGO,

M.M., R.N.

REBECCA B. DE ASIS,
M.A.N., R.N.

A.V.
63-38-47

Handled Delivery

JANICE C. GO, M.A.N., R.N.

EVELYN U. RANCES, M.H.S.,

R.N.

Noted by: MRS. JESUSA M. MAGNO, M.A.N., R.N.

GASCO, D.M., HRM, M.N., R.N.
Clinical Coordinator
PRC I.D No.0136071 Valid Until: December 2017
PNA No.14275
Valid Until: Life member
Date document is signed: ___________Time___________
Highest Nursing Degree Earned: Master of Arts in Nursing
___________Time___________

Approved by:

DR. SOCORRO SALVACION

Dean, College of Nursing

PRC I.D No. 0063136 Valid Until: June 2016
PNA No. 01219 Valid Until: Life member
ADPCN No. 11-192 Valid Until: June 2015
Date document is signed:
Highest Nursing Degree Earned:

Doctor of Management
SUBSCRIBED AND SWORN to before me this ________________________ at Tacloban City by the above parties who presented their
competence evidence of identities.

Doa Remedios Trinidad Romualdez

Medical Foundation

Calanipawan Road, Calanipawan, Tacloban City 6500

Tel. Nos.(053) 321-2345/
rtr1980@yahoo.com

321-4150/

Philippines
325-8353/ 327-5634/

327-1776,

Telefax

Nos.

(053)

327-5506/

327-5004,

E-mail

address:

NEWBORN CARE in EASTERN VISAYAS REGIONAL MEDICAL CENTER, Tacloban

City, Leyte
Prepared by: RALPH SAUL M. MONTESCLAROS
DATE PERFORMED AND
TIME STARTED

PATIENTS INITIALS
(ONLY)
CASE NUMBER

PROCEDURE
PERFORMED

NICU NURSE ON DUTY

(NAME AND SIGNATURE)

SUPERVISED BY CLINICAL
INSTRUCTOR
(NAME AND SIGNATURE)

September 30,2012
Time of Delivery:
12:11PM

Baby Boy P.
58-46-26

Immediate Care of the

Newborn

FE ANELIA G. SIA, R.N.

EUNICE C. PAMANIANARBIS, M.A.N., R.N., R.M.,

B.S.Ed.

May 6,2013
Time of Delivery:
07:14AM

Baby Boy C.
61-33-20

Immediate Care of the

Newborn

ELISSA R. SEVILLA, R.N.

JESUSA M. MAGNO, M.A.N.,

R.N.

Noted by: MRS. JESUSA M. MAGNO, M.A.N., R.N.

GASCO, D.M., HRM, M.N., R.N.
Clinical Coordinator
PRC I.D No.0136071 Valid Until: December 2017
PNA No.14275
Valid Until: Life member
Date document is signed: ___________Time___________
Highest Nursing Degree Earned: Master of Arts in Nursing
___________Time___________

Approved by:

DR. SOCORRO SALVACION

Dean, College of Nursing

PRC I.D No. 0063136 Valid Until: June 2016
PNA No. 01219 Valid Until: Life member
ADPCN No. 11-192 Valid Until: June 2015
Date document is signed:

Highest Nursing Degree Earned:

Doctor of Management
SUBSCRIBED AND SWORN to before me this ________________________ at Tacloban City by the above parties who presented their
competence evidence of identities.