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OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST.

HILTOP MANSION HEIGHTS, LAGRO, QUEZON CITY Name of Student: MONTECILLO CLARISSA IBARRIENTOS __ _ Name and Address of School: OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST.,HILLTOP MANSION HEIGHTS, LAGRO,QUEZON CITY Accreditation Level (if any): PACUCOA LEVEL II___________________ Year Granted: APRIL 10, 2002________________________________________ Date School/Program was Recognized: APRIL 25, 2001 Number: 033 Year: 2001 First Course (if any):NOT APPLICABLE ___School Graduated From: NOT APPLICABLE Year: NOT APPLICABLE ___ Year of Admission in the Bachelor of Science in Nursing Program: JUNE 2006 Year Graduated (BSN Program): MARCH 2010 I. Major Operations
No .
1.

Date of Operation October 31 2008 November 20, 2008 February 03, 2009 January 31, 2010 February 17, 2010

Case No. 01470

Name of Patient Ginalyn E. Ruiz

Diagnosis Pregnancy uterine 33 weeks age of gestation transverse in labor gravida 3 para 2 Cataract senile mature left eye

Operation Performed Emergency Caesarian

Type of Anesthesia Spinal Anesthesia Monitored Anesthesia care Monitored Anesthesia care General Anesthesia Spinal Anesthesia

Name of Surgeon Dr. Imelda Carreon Dr. Ronaldo fernando Dr. Ronaldo Fernando Dr. James Hernandez Dr. Imelda Carreon

Name of Hospital United Balagtas Doctors Hospital Corporation United Balagtas Doctors Hospital Corporation United Balagtas Doctors Hospital Corporation United Balagtas Doctors Hospital Corporation United Balagtas Doctors Hospital Corporation

Supervised by Qualified CI Wilowena Angeles RN, MAN PRC No. 304439 PNA No. 2011-061316 Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316 Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316 Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316 Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316

Signature of Qualified C.I.

2.

01503

Arnedo P. Pacheco Priscilla Bautista Ronnie Catindig

Cataract extraction

3.

01634

Cataract senile mature right eye Fracture of ankle right joint

Cataract extraction

4.

02142

Open manual fixation ankle joint Low transverse caesarian section

5.

02166

Lorena Dionisio

Pregnancy uterine 40 weeks age of gestation transverse in presentation gravida 1 para 0

Prepared by: Montecillo Clarissa I. Signature over printed Name of Student Supervised by: Wilowena Angeles RN,MAN Signature over printed Name of Faculty Date Signed: ________ Degree: BSN MAN a.) PRC NO: 304439 Valid Until: February 12, 2015 b.) PNA NO: 2012-826680 Valid Until: December 2012

Noted by: LIza May B. Jecino RN,MAN Signature over printed Name of Clinical Coordinator Date Signed: _________ Degree: BSN MAN a.)PRC NO: 164056 Valid Until: January 25, 2013 b.) PNA NO: 2011-17397 Valid Until: Lifetime

Concurred by: Lorna Punongbayan Diano RN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: RN a.) PRC NO: 0260345 Valid Until: March 21, 2013 b.) PNA NO: 2011-087335 Valid Until: October 2011

Approved by: Nelia R. Capulong RN,RM,MAN Signature over printed Name of Dean Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0041904 Valid Until: July 31,2012 b.) PNA NO: 18698 Valid Until: Lifetime c.) ADPCN NO: 0627 Valid Until: December 2011

OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST., HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY Name of Student: MONTECILLO CLARISSA IBARRIENTOS Name and Address of School: OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST.HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY Accreditation Level (if any): PACUCOA LEVEL II Year Granted .APRIL 10 2002 Date School/Program was Recognized: APRIL 25, 2001 Number: 033 ____Year: 2001 First Course (if any):NOT APPLICABLE School Graduated From: NOT APPICABLE Year: NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: JUNE 2006 Year Graduated (BSN Program): MARCH 2010 II. Minor Operations
No. 1. Date of Operation September 28, 2008 November 5, 2008 November 5, 2008 January 26, 2010 Case No. 89470 Name of Patient Nathan Dumantang Melita D. Naing Diagnosis Lacerated wound 2nd digit left hand Hypogastric pain Operation Performed Suturing Type of Anesthesia Local Anesthesia Local Anesthesia Spinal Anesthesia Local Anesthesia Name of Surgeon Dr. Asis Name of Hospital United Balagtas Doctors Hospital Corporation United Balagtas Doctors Hospital Corporation United Balagtas Doctors Hospital Corporation Ospital ng Sampaloc Supervised by Qualified CI Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316 . Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316 . Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316 Carmelita S. Vitug RN,RM,MAN PRC No. 266517 PNA No. 18470 Marcellus Belisario RN, MAN PRC. No. 0349993 PNA No. 19636 Approved by: Nelia R. Capulong RN,RM,MAN Signature over printed Name of Dean Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0041904 Valid Until: July 31,2012 b.) PNA NO: 18698 Valid Until: Lifetime c.) ADPCN NO: 0627 Valid Until: December 2011 Signature of Qualified CI

___ ____ ____ _ ____ ____

2.

01479

Colonoscopy

Dr. Michael Bunyi

3.

00363

Mary Grace Abellano Antonio Ballesteros

Incomplete Abortion Non-healing wound left foot

Dilatation and Curretage Debridement

Dr. Imelda Carreon

4.

678500

Dr. Christopher Orozco

5.

March 03, 2010

155015

Nenita Agustin

Incomplete abortion

Dilatation and Curretage

Intravenous Sedation

Dr. Maria Agnes Bautista

Bulacan Maternity and Childrens Hospital

Prepared by: Montecillo Clarissa I. Signature over printed Name of Student Supervised by: Wilowena Angeles RN,MAN Signature over printed Name of Faculty Date Signed: ________ Degree: BSN MAN a.) PRC NO: 304439 Valid Until: February 12, 2015 b.) PNA NO: 2012-826680 Valid Until: December 2012

Noted by: LIza May B. Jecino RN,MAN Signature over printed Name of Clinical Coordinator Date Signed: _________ Degree: BSN MAN a.)PRC NO: 164056 Valid Until: January 25, 2013 b.) PNA NO: 2011-17397 Valid Until: Lifetime

Concurred by: Lorna Punongbayan Diano RN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: RN a.) PRC NO: 0260345 Valid Until: March 21, 2013 b.) PNA NO: 2011-087335 Valid Until: October 2011

Concurred by: Minerva Espino RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0090530 Valid Until: October 10, 2012 b.) PNA NO: 19638 Valid Until: Lifetime

Concurred by: Grace D. Zaldua RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0142514 Valid Until: May 26, 2012 b.) PNA NO: 15062 Valid Until: Lifetime

OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST., HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY Name of Student: MONTECILLO CLARISSA IBARRIENTOS ___ ___________________________________________________________________________________________________________________________________ Name and Address of School: OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST.,HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY __ Accreditation Level (if any): PACUCOA LEVEL II Year Granted: APRIL 10 2002 Date School/Program was Recognized: APRIL 25, 2001 _ Number: 033 __ __Year: 2001 _ First Course (if any): NOT APPLICABLE _ School Graduated From: Year: NOT APPICABLE _ _ _ Year of Admission in the Bachelor of Science in Nursing Program: JUNE 2006 ____ Year Graduated (BSN Program): MARCH 2010 ___ III. Actual Deliveries
No. 1.

Case No. 159-09

Diagnosis Pregnancy uterine full term cephalic in labor gravida 4 para 4 Pregnacy uterine full term cephalic in labor gravida 1 para 0 Pregnancy uterine full term cephalic in labor gravida 2 para 1 Pregnancy uterine 40 weeks age of gestation cephalic in labor gravida 1 para 0 Pregnancy uterine 39 weeks age of gestation cephalic in labor gravida 2 para 1

Name of Mother WInifreda Estadola Harlene Lara

Age 34

Date of Delivery June 01, 2009 March 04,2009 March 20, 2009 March 17, 2010 March 17, 2010

Time of Delivery 9:03 am

Gender of Baby Female

Name of Hospital Camarin health center and Lying-in Camarin health center and Lying-in Camarin health center and Lying-in Bulacan Maternity and Childrens Hospital Bulacan Maternity and Childrens Hospital

Type of Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery

Supervised by: Qualified C.I. Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Emelita Bulos RM, RN, MAN PRC No: 192498 PNA No: 026809 Emelita Bulos RM, RN, MAN PRC No: 192498 PNA No: 026809 Approved by: Nelia R. Capulong RN,RM,MAN Signature over printed Name of Dean Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0041904 Valid Until: July 31,2012 b.) PNA NO: 18698 Valid Until: Lifetime c.) ADPCN NO: 0627 Valid Until: December 2011

Signature of Qualified CI

2.

068-9

20

8:40 am

Female

3.

078-09

Nenita Yape

20

8:00 am

Female

4.

153169

Glenda Arellano

28

10:10 am 9:20 am

Male

5.

152672

Karissa Louise Tadifa

28

Female

Prepared by: Montecillo Clarissa I. Signature over printed Name of Student Supervised by: Imelda Villegas RN, MAN Signature over printed Name of Faculty Date Signed: ________ Degree: BSN MAN a.) PRC NO: 69342 Valid Until: November 11, 2013 b.) PNA NO: 2012- 023957 Valid Until: December 2012

Noted by: LIza May B. Jecino RN,MAN Signature over printed Name of Clinical Coordinator Date Signed: _________ Degree: BSN MAN a.)PRC NO: 164056 Valid Until: January 25, 2013 b.) PNA NO: 2011-17397 Valid Until: Lifetime

Concurred by: Norma A. Manere RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0082296 Valid Until: May 23, 2011 b.) PNA NO: 3805 Valid Until: Lifetime

Concurred by: Minerva Espino RN MAN Signature over printed Name of Chief Nurse Date Sugned:_________ Degree: BSN MAN a.) PRC NO: 0090530 Valid Until: October 10, 2012 b.) PNA NO: 19638 Valid Until: Lifetime

OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST., HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY Name of Student: MONTECILLO CLARISSA IBARRIENTOS ___ Name and Address of School: OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST.,HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY ____ Accreditation Level (if any): PACUCOA LEVEL II Year Granted: APRIL 10 2002 _____ Date School/Program was Recognized: APRIL 25, 2001 Number: 033 Year: 2001 ____ First Course (if any): NOT APPLICABLE School Graduated From: NOT APPLICABLE Year: NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: JUNE 2006 ____ Year Graduated (BSN Program): MARCH 2010______________________________________________________________________________________ IV. Deliveries Assisted
No. 1.

___

Case No. 20051832

Diagnosis Pregnancy uterine full term premature rupture of membrane gravida 1 para 0 Pregnancy uterine full term cephalic in labor gravida 2 para 1 Pregnancy uterine full term cephalic in labor gravida 1 para 0 Pregnancy uterine full term cephalic in labor gravida 2 para 1 Pregnancy uterine full term cephalic in labor gravida 2 para 1

Name of Mother Rizalyn Painogan Irene Campto

Age 21

Date of Delivery July 07, 2008

Time of Delivery 1:20 pm

Gender of Baby Female

Name of Hospital Gregorio H. Del Pilar hospital Camarin health center and Lying-in Camarin health center and Lying-in Camarin health center and Lying-in Camarin health center and Lying-in

2.

074-09

27

March 10, 2009

1:45 am

Male

3.

075-09

Mary Jane Anson Ruby Tolibas

20

March 10, 2009

11:44 am

Female

4.

076-09

30

March 12, 2009

1:05 am

Female

5.

153339

Teresita Humanoy

21

March 17, 2009

1:05 pm

Male

Type of Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery

Supervised by Qualified C.I. Cecile F. Guevarra, RN, MAN PRC No. 293775 PNA No. 18471 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531

Signature of Qualified C.I.

Prepared by: Montecillo Clarissa I. Signature over printed Name of Student Supervised by: Imelda Villegas RN, MAN Signature over printed Name of Faculty Date Signed: ________ Degree: BSN MAN a.) PRC NO: 69342 Valid Until: November 11, 2013 b.) PNA NO: 2012- 023957

Noted by: LIza May B. Jecino RN,MAN Signature over printed Name of Clinical Coordinator Date Signed: _________ Degree: BSN MAN a.)PRC NO: 164056 Valid Until: January 25, 2013 b.) PNA NO: 2011-17397 Valid Until: Lifetime

Concurred by: Norma A. Manere RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0082296 Valid Until: May 23, 2011 b.) PNA NO: 3805 Valid Until: Lifetime

Concurred by: Minerva Espino RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0090530 Valid Until: October 10, 2012 b.) PNA NO: 19638 Valid Until: Lifetime

Concurred by: Arlene Galang-Generosa RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO:152240 Valid Until: October 19, 2014 b.) PNA NO: 18248 Valid Until: Lifetime

Approved by: Nelia R. Capulong RN,RM,MAN Signature over printed Name of Dean Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0041904 Valid Until: July 31,2012 b.) PNA NO: 18698 Valid Until: Lifetime c.) ADPCN NO: 0627 Valid Until: December 2011

Valid Until: December 2012

OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST., HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY Name of Student: MONTECILLO CLARISSA IBARRIENTOS Name and Address of School: OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST.,HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY Accreditation Level (if any): PACUCOA LEVEL II Year Granted: APRIL 10 2002 Date School/Program was Recognized: APRIL 25, 2001 __Number: 033 _ Year: 2001 _ First Course (if any): NOT APPLICABLE _ School Graduated From: NOT APPLICABLE Year: NOT APPICABLE _ Year of Admission in the Bachelor of Science in Nursing Program: JUNE 2006 Year Graduated (BSN Program): MARCH 2010 V. Cord Dressing
No. 1. Case No. 00371 Date Performed November 20, 2008 Name of Baby Baby girl Galvez Gender of Baby Female Name of Mother Arlene Galvez Age 27 Name of Hospital United Balagtas Doctors Hospital Corporation Supervised by Qualified C.I. Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Emelita Bulos RM, RN, MAN PRC No: 192498 PNA No: 026809 Concurred by: Lorna Punongbayan Diano RN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: RN a.) PRC NO: 0260345 Valid Until: March 21, 2013 b.) PNA NO: 2011-087335 Valid Until: October 2011 Approved by: Nelia R. Capulong RN,RM,MAN Signature over printed Name of Dean Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0041904 Valid Until: July 31,2012 b.) PNA NO: 18698 Valid Until: Lifetime c.) ADPCN NO: 0627 Valid Until: December 2011 Signature of Qualified C.I.

_ ____ _____ _ ____ ___

2.

070-09

March 05, 2009

Baby boy Leguani

Male

Elma Leguani

27 Camarin health center and Lying-in

3.

071-09

March 06, 2009

Baby girl Odon

Female

Abegail Odon

18 Camarin health center and Lying-in

4.

077-09

March 08, 2009

Baby girl Quesada

Female

Sheryl Quesada

21 Camarin health center and Lying-in

5.

151014

March 18, 2010

Baby boy Caparas

Male

Marilou Caparas

21

Bulacan Maternity and Childrens Hospital

Prepared by: Montecillo Clarissa I. Signature over printed Name of Student Supervised by: Imelda Villegas RN, MAN Signature over printed Name of Faculty Date Signed: ________ Degree: BSN MAN a.) PRC NO: 69342 Valid Until: November 11, 2013 b.) PNA NO: 2012- 023957 Valid Until: December 2012

Noted by: LIza May B. Jecino RN,MAN Signature over printed Name of Clinical Coordinator Date Signed: _________ Degree: BSN MAN a.)PRC NO: 164056 Valid Until: January 25, 2013 b.) PNA NO: 2011-17397 Valid Until: Lifetime

Concurred by: Norma A. Manere RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0082296 Valid Until: May 23, 2011 b.) PNA NO: 3805 Valid Until: Lifetime

Concurred by: Minerva Espino RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0090530 Valid Until: October 10, 2012 b.) PNA NO: 19638 Valid Until: Lifetime

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