DR. YANGAS COLLEGES, INC.

(Formerly DR. YANGAS FRANCISCO BALAGTAS COLLEGES) 182 Mc Arthur Highway, Wakas, Bocaue, Bulacan Tel.Nos.(044)692-3097/692-5291/Fax No. (044)920-0289 Website:www.thedycian.com PACUCOA LEVEL I FORMAL ACCREDITED STATUS, FEBRUARY 2011 FEBRUARY 2014

ODC Form 1A ACTUAL DELIVERY FORM

ACTUAL DELIVERY in __Ospital ng Lungsod ng San Jose Del Monte / Area E City San Jose Del Monte Bulacan
Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student __SALONGA, EFEPANIO CARPIO
Date Performed And Time Started Patients INITIAL Only

PROCEDURE PERFORMED

D.R. Nurse On Duty

(Name and Signature) (If Midwife on Duty, Signature Not Required)

SUPERVISED BY
Clinical Instructor Name and Signature

Case Number
(not applicable for Birthing/Lying-in Clinical/Homes)

July 2,2010 6:35 am December 13, 2011 9:40 pm

S.M.A. 41.31.10 V.J

Normal Spontaneous Delivery Normal Spontaneous Delivery

Dennis Cailing R.N Lennelyn Maestre, R.N

Gerlita J. Pio R.N, M.A.N Lina D. Ouano R.N, M.A.N

Noted by: Marlon C. Guballa, RN,MAN_ Print Name and Signature Clinical Coordinator, PRC I.D. No. _0373339_ Valid Until May 2014____ Date document is signed: ________________ Time ____________ Specify Highest Nursing Degree Earned: _MAN_______

Approved by: __PROF. TEODORA M. DELOS REYES, RN, DNS Print Name and Signature Dean, PRC I.D. No. ___0055264__ Valid Until _April 2012______ Date document is signed: ________________ Time ____________ Specify Highest Nursing Degree Earned: _DNS___________

DR. YANGAS COLLEGES, INC.

(Formerly DR. YANGAS FRANCISCO BALAGTAS COLLEGES) 182 Mc Arthur Highway, Wakas, Bocaue, Bulacan Tel.Nos.(044)692-3097/692-5291/Fax No. (044)920-0289 Website:www.thedycian.com PACUCOA LEVEL I FORMAL ACCREDITED STATUS, FEBRUARY 2011 FEBRUARY 2014

ODC Form 1A ACTUAL DELIVERY FORM

ACTUAL DELIVERY in __Mary Immaculate Maternity Hospital

Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student __SALONGA, EFEPANIO CARPIO
Date Performed And Time Started Patients INITIAL Only

PROCEDURE PERFORMED

D.R. Nurse On Duty

(Name and Signature) (If Midwife on Duty, Signature Not Required)

SUPERVISED BY
Clinical Instructor Name and Signature

Case Number
(not applicable for Birthing/Lying-in Clinical/Homes)

April 7,2010 7:00 pm

C.K. 10-103

Normal Spontaneous Delivery

Leonila H. Antonio, RM,RN,MAN

Noted by: Marlon C. Guballa, RN, MAN__ Print Name and Signature Clinical Coordinator, PRC I.D. No. 0373339 Valid Until May 2014 Date document is signed: ________________ Time ____________ Specify Highest Nursing Degree Earned: _MAN______________

Approved by: __PROF. TEODORA M. DELOS REYES, RN, DNS Print Name and Signature Dean, PRC I.D. No. ___0055264__ Valid Until _April 2012______ Date document is signed: ________________ Time ____________ Specify Highest Nursing Degree Earned: _DNS__________

DR. YANGAS COLLEGES, INC.

(Formerly DR. YANGAS FRANCISCO BALAGTAS COLLEGES) 182 Mc Arthur Highway, Wakas, Bocaue, Bulacan Tel.Nos.(044)692-3097/692-5291/Fax No. (044)920-0289 Website:www.thedycian.com PACUCOA LEVEL I FORMAL ACCREDITED STATUS, FEBRUARY 2011 FEBRUARY 2014

ODC Form 1B ASSISTED DELIVERY FORM

ASSISTED DELIVERY in _ Ospital ng Lungsod ng San Jose Del Monte / Area E City San Jose Del Monte Bulacan
Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student __ SALONGA, EFEPANIO CARPIO__
Date Performed And Time Started Patients INITIAL Only

PROCEDURE PERFORMED
ASSISTED DELIVERY
Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery

D.R. Nurse On Duty

(Name and Signature) (If Midwife on Duty, Signature Not Required)

SUPERVISED BY
Clinical Instructor Name and Signature

Case Number
(not applicable for Birthing/Lying-in Clinical/Homes)

December 7, 2011 10:30 pm December 8, 2011 8:00 pm December 14, 2011 6:50 pm

R.M K. A. M.A

Gretchen Ape R.N Katherine Mae Diaz R.N Katherine Mae Diaz R.N

Lina D. Ouano R.N, M.A.N Lina D. Ouano R.N, M.A.N Lina D. Ouano R.N, M.A.N

Noted by: Marlon C. Guballa, R.N, M.A.N__ Print Name and Signature Clinical Coordinator, PRC I.D. No.0373339 Valid Until May 2014 Date document is signed: ________________ Time ____________ Specify Highest Nursing Degree Earned: _MAN___________

Approved by: __PROF. TEODORA M. DELOS REYES, RN, DNS Print Name and Signature Dean, PRC I.D. No. ___0055264__ Valid Until _April 2012______ Date document is signed: ________________ Time ____________ Specify Highest Nursing Degree Earned: __DNS___________

DR. YANGAS COLLEGES, INC.

(Formerly DR. YANGAS FRANCISCO BALAGTAS COLLEGES) 182 Mc Arthur Highway, Wakas, Bocaue, Bulacan Tel.Nos.(044)692-3097/692-5291/Fax No. (044)920-0289 Website:www.thedycian.com PACUCOA LEVEL I FORMAL ACCREDITED STATUS, FEBRUARY 2011 FEBRUARY 2014

ODC Form 1C CORD CARE FORM

IMMEDIATE NEWBORN CORD CARE in __Our Lady of Mercy General Hospital_

Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student_ SALONGA, EFEPANIO CARPIO
Date Performed And Time Started Patients INITIAL Only Immediate Newborn Cord Care Nurse On Duty
(Name and Signature) (If Midwife on Duty, Signature Not Required)

PERFORMED
Indicate where performed eg. D.R., Nursery, NICU, or Home Case Number
(not applicable for Birthing/Lying-in Clinical/Homes)

SUPERVISED BY
Clinical Instructor Name and Signature

November 27, 2011 12:30 pm November 28, 2011 9:12 am November 29, 2011 7:47 am

Baby Girl M. 001305 Baby Girl B. 001308 Baby Girl E. 001312

Neonatal Intensive Care Units Neonatal Intensive Care Units Neonatal Intensive Care Units

Maryette Cruz, R.N. Isra meshech Viernes, R.N. Paula Ramon, R.N

Liwayway Timpoc R.N, M.A.N Liwayway Timpoc R.N, M.A.N Liwayway Timpoc R.N, M.A.N

Noted by: _ Marlon C. Guballa, RN, MA._______________ Print Name and Signature Clinical Coordinator, PRC I.D. No. 0373339 Valid Until May 2014 Date document is signed: ________________ Time ____________ Specify Highest Nursing Degree Earned: _MAN_______________

Approved by: __PROF. TEODORA M. DELOS REYES, RN, DNS Print Name and Signature Dean, PRC I.D. No. ___0055264__ Valid Until _April 2012______ Date document is signed: ________________ Time ____________ Specify Highest Nursing Degree Earned: _DNS____________

DR. YANGAS COLLEGES, INC.

(Formerly DR. YANGAS FRANCISCO BALAGTAS COLLEGES) 182 Mc Arthur Highway, Wakas, Bocaue, Bulacan Tel.Nos.(044)692-3097/692-5291/Fax No. (044)920-0289 Website:www.thedycian.com PACUCOA LEVEL I FORMAL ACCREDITED STATUS, FEBRUARY 2011 FEBRUARY 2014

ODC Form 2A O.R. SCRUB FORM Major

SURGICAL SCRUB in _ Our Lady of Mercy General Hospital_

Hospital, Municipality/City/Province

Prepared by: Printed Name and Signature of Student _ SALONGA, EFEPANIO CARPIO
Date Performed And Time Started Patients INITIAL Only O.R. Nurse On Duty SUPERVISED BY
Clinical Instructor Name and Signature

Case Number

SURGICAL PROCEDURE PERFORMED

Low Transverse Caesarean Section Herniorrhapy Right

(Name and Signature)

November 28, 2011 10:00 am November 29, 2011 10:15 am

N.R.A.D 04410 B.P 04418

Isra Meshech Viernes, R.N Paula Ramon, R.N

Liwayway Timpoc R.N, M.A.N Liwayway Timpoc R.N, M.A.N

Noted by: _Marlon C. Guballa_RN, MAN___________________ Print Name and Signature Clinical Coordinator, PRC I.D. No. 0373339 Valid Until May 2014 Date document is signed: ________________ Time ____________ Specify Highest Nursing Degree Earned: _ MAN__________

Approved by: __PROF. TEODORA M. DELOS REYES, RN, DNS Print Name and Signature Dean, PRC I.D. No. ___0055264__ Valid Until _April 2012______ Date document is signed: ________________ Time ____________ Specify Highest Nursing Degree Earned: _DNS______

DR. YANGAS COLLEGES, INC.

(Formerly DR. YANGAS FRANCISCO BALAGTAS COLLEGES) 182 Mc Arthur Highway, Wakas, Bocaue, Bulacan Tel.Nos.(044)692-3097/692-5291/Fax No. (044)920-0289 Website:www.thedycian.com PACUCOA LEVEL I FORMAL ACCREDITED STATUS, FEBRUARY 2011 FEBRUARY 2014

ODC Form 2A O.R. SCRUB FORM Major

SURGICAL SCRUB in _ Rizal Medical Center/ Shaw Boulevard/ Pasig City_

Hospital, Municipality/City/Province

Prepared by: Printed Name and Signature of Student _ SALONGA, EFEPANIO CARPIO
Date Performed And Time Started Patients INITIAL Only O.R. Nurse On Duty SUPERVISED BY
Clinical Instructor Name and Signature

Case Number

SURGICAL PROCEDURE PERFORMED

Total Mastectomy Right

(Name and Signature)

January 9,2012 10:10 am

V.A 44445

Cecilia Sube, RN,

Aurora P. Vianzon, RN, MAN

Noted by: _Marlon C. Guballa_RN, MAN___________________ Print Name and Signature Clinical Coordinator, PRC I.D. No. 0373339 Valid Until May 2014 Date document is signed: ________________ Time ____________ Specify Highest Nursing Degree Earned: _ MAN__________

Approved by: __PROF. TEODORA M. DELOS REYES, RN, DNS Print Name and Signature Dean, PRC I.D. No. ___0055264__ Valid Until _April 2012______ Date document is signed: ________________ Time ____________ Specify Highest Nursing Degree Earned: _DNS______

DR. YANGAS COLLEGES, INC.

(Formerly DR. YANGAS FRANCISCO BALAGTAS COLLEGES) 182 Mc Arthur Highway, Wakas, Bocaue, Bulacan Tel.Nos.(044)692-3097/692-5291/Fax No. (044)920-0289 Website:www.thedycian.com PACUCOA LEVEL I FORMAL ACCREDITED STATUS, FEBRUARY 2011 FEBRUARY 2014

ODC Form 2B O.R. CIRCULATING FORM

SURGICAL Circulating Rizal Medical Center/ Shaw Boulevard/ Pasig ________

Hospital, Municipality/City/Province

Prepared by: Printed Name and Signature of Student : SALONGA, EFEPANIO CARPIO
Date Performed And Time Started Patients INITIAL Only O.R. Nurse On Duty SUPERVISED BY
Clinical Instructor Name and Signature

SURGICAL PROCEDURE PERFORMED

Case Number

(Name and Signature)

September 3, 2010 7:10 pm January 10,2012 11:00 am January 10,2012 8:15 am

R.R 63751 E.P 95269 D.P.P A-100589

Appendectomy Evisceration Left Eye Low Transverse Caesarean Section II

Jerome Tinte, RN Mary Grace Rivera, RN Ma. Lourdes Mozo, RN

Aurora P. Vianzon, RN, MAN Aurora P. Vianzon, RN, MAN Aurora P. Vianzon, RN, MAN

Noted by: _Marlon C. Guballa_RN, MAN___________________ Print Name and Signature Clinical Coordinator, PRC I.D. No. 0373339 Valid Until May 2014 Date document is signed: ________________ Time ____________ Specify Highest Nursing Degree Earned: _ MAN__________

Approved by: __PROF. TEODORA M. DELOS REYES, RN, DNS Print Name and Signature Dean, PRC I.D. No. ___0055264__ Valid Until _April 2012______ Date document is signed: ________________ Time ____________ Specify Highest Nursing Degree Earned: __DNS____________