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PROFESSIONAL REGULATION COMMISSION

Manila
BOARD OF MIDWIFERY
Record of Actual Deliveries Handled
Please Check if applicant is:

Graduate Midwife Registered Nurse

Name of Applicant: JAIMILLY M. ABUTAN School: EMILIO AGUINALDO COLLEGE-CAVITE


Supervised by:
Check
Case Complete Diagnosis Date & Full Name, Address of if Home
Name of Patient Number Gravida-Para Time Facility & Contact Number Del. Position/ License
Printed Name & Designation Signature No./Expiration
Performed
Contact No. Date
1. Guda, Eunilyn Gravida 2 Para 2 Pregnancy Uterine 37 wks
Jan 11, 2018 Pagamutan ng Dasmarinas
Blk A-12 Lot 2 San Luis II 00258 AOG via Normal Spontaneous Delivery to Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
4:37 pm Sept. 1, 2020
Dasmariňas, Cavite an alive Baby Boy, 3800gms @ 4:37 pm 09175790079 Instructor
with 2nd degree laceration
2. Recto, Lovelie Gravida 2 Para 2 Pregnancy Uterine 40 wks
Jan 15, 2018 Pagamutan ng Dasmarinas
Blk. 39 lot 14 Bahay 00264 and 3 days AOG via Normal Spontaneous Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
5:48 pm Sept. 1, 2020
Pangarap sampaloc IV Delivery to an alive Baby Girl, 2900gms @ 09175790079 Instructor
Dasmariňas, Cavite 5:48 pm
3. Clapis, Libunao Gravida 1 Para 1 Pregnancy Uterine 40wks
Jan 29, 2018 Pagamutan ng Dasmarinas
Blk.135 Lot 36 Ph.1 Mabuhay AOG via Normal Spontaneous Delivery to Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
7:00am Sept. 1, 2020
Subdivision Palipara 3 00274 an alive Baby Boy, 3000gms @ 1:30 pm 09175790079 Instructor
Dasmariňas, Cavite with 2nd degree laceration
4. Dicen, Karen Gravida 6 Para 5 Pregnancy Uterine 40 wks
Jan 30, 2018 Pagamutan ng Dasmarinas
B-167 Lot 27 ph. 4 Paliparan 00276 and 3 days AOG via Normal Spontaneous Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
III Dasmariňas, Cavite 3:10 pm Sept. 1, 2020
Delivery to an alive Baby Girl, 3600gms @ 09175790079 Instructor
3:10 pm
5. Castillo, Cristhel Gravida 1 Para 1 Pregnancy Uterine 41 wks
Feb 06, 2018 Pagamutan ng Dasmarinas
Private Lot Barangay 002821 and 3 days AOG via Normal Spontaneous Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
11:32 pm Sept. 1, 2020
Burol 3 Dasmariňas, Delivery to an alive Baby Girl, 2700gms @ 09175790079 Instructor
Cavite 11:32 pm
7. Escoradado, Jorja Biga 00280 Gravida 2 Para 2 Pregnancy Uterine 38 wks
Feb 06, 2018 Pagamutan ng Dasmarinas
I Silang Cavite Blk. 61 Lot and 3 days AOG via Normal Spontaneous Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
Delivery to an alive Baby Girl, 3200gms @ 9:40 pm Sept. 1, 2020
24 Victoria Reyes 09175790079 Instructor
Dasmariňas, Cavite 9:40 pm

8. Castillo, Cristhel 00281 Gravida 1 Para 1 Pregnancy Uterine 41 wks


Feb 08, 2018 Pagamutan ng Dasmarinas
Private Lot Brgy. Burol 3 AOG via Normal Spontaneous Delivery to Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
11:32 pm Sept. 1, 2020
Dasmariňas, Cavite. an alive Baby Girl, 2700gms @ 11:32 pm 09175790079 Instructor
with 1st degree laceration

9. Rebullido, Liza Mae 00283 Gravida 3 Para 3 Pregnancy Uterine 38 wks


Feb 10, 2018 Pagamutan ng Dasmarinas
Blk 90, Lot 5 Bahay Pangarap AOG via Normal Spontaneous Delivery to Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
7:33 am Sept. 1, 2020
Subd, Sampaloc IV an alive Baby Girl, 4300gms @ 7:33 am 09175790079 Instructor
Dasmariňas, Cavite.
10. Ebia, Marie Cris 00290 Gravida 5 Para 5 Pregnancy Uterine 38 wks
Feb 21, 2018 Pagamutan ng Dasmarinas
Blk 7 Lot 34 Ph.9 Golden AOG via Normal Spontaneous Delivery to Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
9:55 am Sept. 1, 2020
City Dasmariňas, Cavite. an alive Baby Girl @ 9:55 am 09175790079 Instructor
11. Mendoza, Jennifer 00295 Gravida 1 Para 1 Pregnancy Uterine 39 wks
Mar 10, 2018 Pagamutan ng Dasmarinas
0700 Almond St. Summit AOG via Normal Spontaneous Delivery to Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
an alive Baby Girl, 3600gms @ 2:35 am 2:35 pm Sept. 1, 2020
Circle Muntilupa City 09175790079 Instructor
with 2nd degree laceration
12. Orbita, Jennifer 00296 Gravida 3 Para 2 Pregnancy Uterine 39 wks
Mar 12, 2018 Pagamutan ng Dasmarinas
Blk.87 Excess lot Fatima II and 5 days AOG via Normal Spontaneous Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
11:35 pm Sept. 1, 2020
Dasmariňas, Cavite. Delivery to an alive Baby Girl, 2600gms 09175790079 Instructor
11:35 pm
13. Adopina, Kristen 00299 Gravida 1 Para 1 Pregnancy Uterine 38 wks
Mar 26, 2018 Pagamutan ng Dasmarinas
Ph.1 Blk. 48 lot Mary Cris and 2 days AOG via Normal Spontaneous Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
Complex Gen. Trias Cavite Delivery to an alive Baby Boy, 2500gms 7:28 am Sept. 1, 2020
09175790079 Instructor
7:28 am
14. Cos, Ma. Jasmine 00301 Gravida 1 Para 1 Pregnancy Uterine 40 wks
Pagamutan ng Dasmarinas
Blk.11 E-3 Lot 2 Brgy. San and 5 days AOG via Normal Spontaneous Mar 27, 2018 Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
Burol 1, City of Dasmarinas, Cavite
7:25pm Sept. 1, 2020
Andres I Area C Delivery to an alive Baby Boy, 2500gms 09175790079 Instructor
Dasmariňas, Cavite. 7:25pm
15. Columbus, Jona-Anne 00303 Gravida 3 Para 3 Pregnancy Uterine 41 wks
Mar 31, 2018 Pagamutan ng Dasmarinas
#600 Happy Road AOG via Normal Spontaneous Delivery to Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
an alive Baby Girl, 2600gms 3:50 am 3:50am Sept. 1, 2020
Kaibagan tagaytay City 09175790079 Instructor
16. Yulo, Jobel 00304 Gravida 2 Para 2 Pregnancy Uterine 38 wks
Apr 3, 2018 Pagamutan ng Dasmarinas
Blk1-4 lot 5 Zone Bautista and 5 days AOG via Normal Spontaneous Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
Delivery to an alive Baby Boy, 3200gms 3:20am Sept. 1, 2020
prop Sampaloc 4 09175790079 Instructor
Dasmariňas, Cavite. 3:20 am
17. Bayquen, Liberty 00308 Gravida 3 Para 3 Pregnancy Uterine 38 wks
Apr 07, 2018 Pagamutan ng Dasmarinas
Blk.18 Lot 3 and 4 Bahay and 6 days AOG via Normal Spontaneous Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
Delivery to an alive Baby Boy, 3400gms 7:15 am Sept. 1, 2020
Pangarap Sampaloc IV 09175790079 Instructor
Dasmariňas, Cavite. 7:15 am
18. Jamelano, Marisol 00312 Gravida 3 Para 2 Pregnancy Uterine 39 wks
Apr 13, 2018 Pagamutan ng Dasmarinas
Blk.F22 Lot 4 San Nicolas and 2 days AOG via Normal Spontaneous Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
4:45pm Sept. 1, 2020
II Dasmariňas, Cavite. Delivery to an alive Baby Girl, 3200gms 09175790079 Instructor
4:45 pm
19. Vista, Julie Anne 00315 Gravida 3 Para 3 Pregnancy Uterine 39 wks
Apr 16, 2018 Pagamutan ng Dasmarinas
Blk. 19 Lot 26 Victoria Reyes and 2 days AOG via Normal Spontaneous Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
Dasmariňas, Cavite. 8:10am boy Sept. 1, 2020
Delivery to an alive Baby Boy, 3500gms 09175790079 Instructor
8:10 am
20. Sandigan, Maristel 00322 Gravida 1 Para 1 Pregnancy Uterine 38 wks
Apr 26, 2018 Pagamutan ng Dasmarinas
Blk. 19 Lot I Luzviminda II and 2 days AOG via Normal Spontaneous Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
11:20pm Sept. 1, 2020
Dasmariňas, Cavite. Delivery to an alive Baby Boy, 3100gms 09175790079 Instructor
11:20pm with 1st degree laceration
Note: For graduate midwives: Supervision must be by qualified faculty/clinical instructor

SUBSCRIBED AND SWORN to before me this _____________________ at ______________________Affiant exhibiting to me his/her Residence
Certificate No.________________
Issued at_______________on___________________.
CERTIFIED CORRECT:
__________________________________
Administering officer or Notary Public Signature: ____________________Date: _____________
Affix Printed Name: MAGDALENA L. LICMOAN RM, MAT
Designation: PRINCIPAL___________________
Documentary Lic. No.: 0038022 Expiry Date: SEPTEMBER 24, 2020
(to be posted on the last
page)
PROFESSIONAL REGULATION COMMISSION
Manila
BOARD OF MIDWIFERY
Record of Actual Repair of Perineal Laceration

Please Check if applicant is:

Graduate Midwife Registered Nurse

Name of Applicant: JAIMILLY M. ABUTAN School: EMILIO AGUINALDO COLLEGE-CAVITE

Supervised by:
Name of Patient Case Complete Diagnosis Date & Time Full Name, Address of
Number Facility & Contact Number Check
Gravida-Para Performed if Home Printed Name & Position/ Signature License
Del.
Contact No Designation No./Expiration
Date
1. Guda, Eunilyn Gravida 2 Para 2 Pregnancy Uterine 37 wks Jan 11, 2018
Pagamutan ng Dasmarinas
Blk A-12 Lot 2 San Luis II 00258 AOG via Normal Spontaneous Delivery to 6:00 am Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
Sept. 1, 2020
Dasmariňas, Cavite an alive Baby Boy, 3800gms @ 4:37 pm 09175790079 Instructor
with 2nd degree laceration
2. Clapis, Libunao Gravida 1 Para 1 Pregnancy Uterine 40wks Jan 29, 2018
Pagamutan ng Dasmarinas
Blk.135 Lot 36 Ph.1 Mabuhay 00274 AOG via Normal Spontaneous Delivery to 7:00am Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
Subdivision Palipara 3 Sept. 1, 2020
an alive Baby Boy, 3000gms @ 1:30 pm 09175790079 Instructor
Dasmariňas, Cavite
with 2nd degree laceration
3. Castillo, Cristhel Gravida 1 Para 1 Pregnancy Uterine 41 wks Feb 08, 2018
Pagamutan ng Dasmarinas
Private Lot Brgy. Burol 3 00281 AOG via Normal Spontaneous Delivery to 11:32 pm Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
Sept. 1, 2020
Dasmariňas, Cavite. an alive Baby Girl, 2700gms @ 11:32 pm 09175790079 Instructor
with 1st degree laceration
4. Mendoza, Jennifer Gravida 1 Para 1 Pregnancy Uterine 39 wks
Pagamutan ng Dasmarinas
0700 Almond St. Summit 00295 AOG via Normal Spontaneous Delivery to Mar 10, 2018 Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
Sept. 1, 2020
Circle Muntilupa City an alive Baby Girl, 3600gms @ 2:35 am 2:35 pm 09175790079 Instructor
with 2nd degree laceration
5. Sandigan, Maristel Gravida 1 Para 1 Pregnancy Uterine 38 wks
Pagamutan ng Dasmarinas
Blk. 19 Lot I Luzviminda 00322 and 2 days AOG via Normal Spontaneous Apr 26, 2018 Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
Sept. 1, 2020
II Dasmariňas, Cavite. Delivery to an alive Baby Boy, 3100gms 11:20pm 09175790079 Instructor
11:20pm with 1st degree laceration
Note: For graduate midwives: Supervision must be by qualified faculty/clinical instructor

SUBSCRIBED AND SWORN to before me this _____________________ at ______________________Affiant exhibiting to me his/her Residence
Certificate No.________________
Issued at_______________on___________________.

________________________________ CERTIFIED CORRECT:


Administering officer or Notary Public Signature: ____________________ Date: _____________
Printed Name: MAGDALENA L. LICMOAN RM, BSND, MAT
Designation: PRINCIPAL___________________
Lic. No.: 0038022Expiry Date::SEPTEMBER 24, 2020
EMILIO AGUINALDO COLLEGE EDUCATIONAL CORPORATION
Congressional Road East Ave., Burol Main Dasmariñas City Cavite

Name of Applicant: Jaimilly M. Abutan School: EMILIO AGUINALDO COLLEGE-CAVITE


CORD DRESSING RECORD
No. Date Case No. Baby of Sex Type of Delivery Supervised by Remarks
1 07-28-2017 0051 Sampang , Jeramie Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
2 08-29-2017 0093 Contreras, Angelie Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
3 09-04-2017 0099 Dacallos, Cristine Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
4 09-20-2017 0119 Calderon , Wilnor Male Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
5 10-07-2017 0147 Tazarte, Cresta Male Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
6 11-16-2017 00189 Avila, Rosalie Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
7 11-21-2017 00198 Jalayajay, Nicanora Male Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
8 11-28-2017 00212 Bejo , Sheila May Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
9 11-30-2017 00215 Vinoya , Justine Male Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
10 12-02-2017 00217 Orcales , Marjorie Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
11 12-06-2017 00224 Bonior, Mira Flor Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
12 12-21-2017 00238 Nepales, Pauline Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
13 01-10-2018 00256 Bregondo, Bebelyn Male Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
14 01-29-2018 00274 Clapis, Monique Male Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
15 01-30-2018 00276 Deicen , Karen Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
16 02-03-2018 00278 Navales, Rechell Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
17 02-06-2018 00281 Castillo, Cristhel Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
18 02-10-2018 00283 Rebullido , Liza Mae Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
19 02-21-2018 00290 Ebia, Marie Cris Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
20 02-24-2018 00292 Panagsagan, Victoria Male Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
21 03-10-2018 00295 Mendoza, Jennifer Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
22 04-04-2018 00305 Enero, Lucelle Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN
23 04-16-2018 00316 Ortiz, Babiejane Male Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
24 05-07-2018 00330 Agapito, Mayen Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive
25 05-19-2018 00340 Catle, Anna Rose Female Normal Spontaneous Delivery Anna Sincerra D. Quinio RM, RN, MAN Alive

Magdalena L. Licmoan, RM, BSND, MAT Remarks: _________________ Anna Sincerra D. Quinio, RM., RN, MAN
Principal, School of Midwifery Clinical Instructor
License no:0038022 License no: 0084589
Valid Until: SEPTEMBER 24, 2020 Valid Until: September 1, 2020
PROFESSIONAL REGULATION COMMISSION
Manila
BOARD OF MIDWIFERY
Record of Actual IV Insertion/Infusion
Please Check if applicant is:

Graduate Midwife Registered Nurse

Name of Applicant: JAIMILLY M. ABUTAN School: EMILIO AGUINALDO COLLEGE-CAVITE

Supervised by:
Name of Patient Case Complete Diagnosis Date & Full Name, Address of
Number Facility & Contact Check
Gravida-Para Time if Home
Number Printed Name & Position/ Signature License
Performed Del.
Contact No Designation No./Expiration
Date
1. Dicen, Karen Gravida 6 Para 5 Pregnancy Uterine 40 wks
Jan 30, 2018 Pagamutan ng Dasmarinas
B-167 Lot 27 ph. 4 Paliparan 00276 and 3 days AOG via Normal Spontaneous Burol 1, City of Dasmarinas, Cavite Anna Sincerra D. Quinio, RM, RN, MAN Clinical 0084589
III Dasmariňas, Cavite Delivery to an alive Baby Girl, 3600gms @ 3:10 pm Instructor Sept. 1, 2020
09175790079
3:10 pm
2. Ebia, Marie Cris 00290 Gravida 5 Para 5 Pregnancy Uterine 38 wks Pagamutan ng Dasmarinas
AOG via Normal Spontaneous Delivery to Feb 21, 2018 Burol 1, City of Dasmarinas, Cavite Clinical 0084589
Blk 7 Lot 34 Ph.9 Golden Anna Sincerra D. Quinio, RM, RN, MAN
9:55 am Sept. 1, 2020
City Dasmariňas, Cavite. an alive Baby Girl @ 9:55 am 09175790079 Instructor
3. Columbus, Jona-Anne 00303 Gravida 3 Para 3 Pregnancy Uterine 41 wks Pagamutan ng Dasmarinas
#600 Happy Road Kaibagan AOG via Normal Spontaneous Delivery to Mar 31, 2018 Burol 1, City of Dasmarinas, Cavite Clinical 0084589
3:50am
Anna Sincerra D. Quinio, RM, RN, MAN Sept. 1, 2020
tagaytay City an alive Baby Girl, 2600gms 3:50 am 09175790079 Instructor
4. Bayquen, Liberty 00308 Gravida 3 Para 3 Pregnancy Uterine 38 wks Pagamutan ng Dasmarinas
and 6 days AOG via Normal Spontaneous Apr 07, 2018 Burol 1, City of Dasmarinas, Cavite Clinical 0084589
Blk.18 Lot 3 and 4 Bahay Anna Sincerra D. Quinio, RM, RN, MAN
Delivery to an alive Baby Boy, 3400gms 7:15 am Instructor Sept. 1, 2020
Pangarap Sampaloc IV 09175790079
Dasmariňas, Cavite. 7:15 am
5. Vista, Julie Anne 00315 Gravida 3 Para 3 Pregnancy Uterine 39 wks Pagamutan ng Dasmarinas
Blk. 19 Lot 26 Victoria and 2 days AOG via Normal Spontaneous Apr 16, 2018 Burol 1, City of Dasmarinas, Cavite Clinical 0084589
8:10am boy
Anna Sincerra D. Quinio, RM, RN, MAN Sept. 1, 2020
Reyes Dasmariňas, Cavite. Delivery to an alive Baby Boy, 3500gms 09175790079 Instructor
8:10 am

Note: For graduate midwives: Supervision must be by qualified faculty/clinical instructor

SUBSCRIBED AND SWORN to before me this _____________________ at ______________________Affiant exhibiting to me his/her Residence
Certificate No.________________
Issued at_______________on___________________.
CERTIFIED CORRECT:
__________________________________
Administering officer or Notary Public Signature: ____________________ Date: _____________
Printed Name: MAGDALENA L. LICMOAN RM, MAT
Designation: PRINCIPAL___________________
Lic. No.: 0038022Expiry Date::SEPTEMBER 24, 2020

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