ODC Form 2A O.R.

SCRUB FORM Major

LORMA COLLEGES Carlatan, City of San Fernando, La Union (072) 700-2500, Fax Number 242-3628, Lorma.org (ACSCU-AAI Level III RE-ACCREDITED STATUS valid until April 2012) SURGICAL SCRUB in Ilocos Training and Regional Medical Center Parian, San Fernando City, La Union Prepared by:Ocaoi Maverick Taganap Student Date Performed and Time Started November 17, 2011 9:18 am November 10, 2011 7:41 am August 22,2011 7:25 pm Patient's INITIAL Case Number M.A.G. 2011-0027003 V.I.D. 2011-0026299 Q.F.G. 2011-0018868 SURGICAL PROCEDURE PERFORMED Extracapsular Cataract Extraction with Posterior Chamber Insertion of Intraocular Lens Left Eye Emergency Open cholecystectomy, IOC with Tube Drain Open Reduction internal Fixation Intrarepullary Nailing Left Femur O.R. Nurse on Duty SUPERVISED BY Signature of Student________________________________

___________________________ Felix Leo B.Aragon, RN ___________________________ Romel S. Lucina, RN ___________________________ Crisanti H. Alviar, RN

______________________________ Aurelio Manego, RN, MAN (Thesis Writing II) ______________________________ Aurelio Manego, RN, MAN (Thesis Writing II) ______________________________ Aurelio Manego, RN, MAN (Thesis Writing II)

Noted by: Honesto G. Alnas Clinical Coordinator PRC I.D No. 0248316 Valid Until: April 24,2015

Approved by: Ludivina D. Magpali Dean PRC I.D No. 0186484 Valid Until: August 5, 2012

Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN

Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN

ODC Form 2B O.R. CIRCULATING FORM

LORMA COLLEGES Carlatan, City of San Fernando, La Union (072) 700-2500, Fax Number 242-3628, Lorma.org (ACSCU-AAI Level III RE-ACCREDITED STATUS valid until April 2012)

SURGICAL SCRUB in Lorma Medical Center, Carlatan, City of San Fernando, La Union

Prepared by: Ocaoi Maverick Taganap Student Date Performed and Time Started January 19,2011 10:05am Patient's INITIAL Case Number G.L.L. 362368

Signature of Student ________________________________

SURGICAL PROCEDURE PERFORMED PKE with PCIOL Implant Phacoemulsification Post Chamber Intraocular Lens

O.R. Nurse on Duty

SUPERVISED BY

___________________________ Glorifina G. Dacumos, RN

______________________________ Purificacion M. Soriano, RN, MAN (Thesis Writing II)

February 10, 2011 9:50 am

A.M.L. 350604

Cesarean Section

___________________________ Glorifina G. Dacumos, RN

______________________________ Jonalyn Padilla, RN, MAN (Thesis Writing I)

Noted by: Honesto G. Alnas Clinical Coordinator PRC I.D No. 0248316 Valid Until: April 24,2015 Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN

Approved by: Ludivina D. Magpali Dean PRC I.D No. 0186484 Valid Until: August 5, 2012 Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN ODC Form 1A ACTUAL DELIVERY FORM

LORMA COLLEGES Carlatan, City of San Fernando, La Union (072) 700-2500, Fax Number 242-3628, Lorma.org (ACSCU-AAI Level III RE-ACCREDITED STATUS valid until April 2012)

ACTUAL DELIVERY in Ilocos Training and Regional Medical Center . Parian , San Fernando City , La Union

Prepared by: Ocaoi Maverick Taganap Student

Signature of Student________________________________

Date Performed and Time Started

Patient's INITIAL Case Number

PROCEDURE PERFORMED Assisted Delivery Normal Spontaneous Delivery ( with Right Mediolateral Episiotomy ) Normal Spontaneous Delivery ( with Right Mediolateral Episiotomy )

D.R. Nurse on Duty

SUPERVISED BY

June 21,2011 8:25am June 14, 2011 10:26 am

N.L.D. 2011-0012594 C.T.G 2011-0012962

___________________________ Genelyn F.Layno, RN ___________________________ Genelyn F. Layno, RN ___________________________

_______________________________ Consuelo Enano, RN,MAN _______________________________ Consuelo Enano, RN,MAN

_______________________________

Noted by: Honesto G. Alnas Clinical Coordinator PRC I.D No. 0248316 Valid Until: April 24,2015 Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN

Approved by: Ludivina D. Magpali Dean PRC I.D No. 0186484 Valid Until: August 5, 2012 Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN

ODC Form 1B ASSISTED DELIVERY FORM

LORMA COLLEGES Carlatan, City of San Fernando, La Union

(072) 700-2500, Fax Number 242-3628, Lorma.org (ACSCU-AAI Level III RE-ACCREDITED STATUS valid until April 2012)

ACTUAL DELIVERY in Ilocos Training and Regional Medical Center Parian, San Fernando City, La Union

Prepared by:Ocaoi Maverick Taganap Student

Signature of Student_________________________________

Date Performed and Time Started June 15,2011 7:50 am

Patient's INITIAL Case Number

PROCEDURE PERFORMED Assisted Delivery Normal Spontaneous Delivery ( with Right Mediolateral Episiotomy ) Normal Spontaneous Delivery ( with Right Mediolateral Episiotomy )

D.R. Nurse on Duty

SUPERVISED BY

W.B.M 2011-0012722

___________________________ GenelynF. Layno, RN

_______________________________ Consuelo Enano, RN,MAN

June 22,2011 8:25 am

L.D.B 2011-0018923

___________________________ Ligaya F. Valdez, RN

_______________________________ Consuelo Enano, RN,MAN

Noted by: Honesto G. Alnas Clinical Coordinator PRC I.D No. 0248316 Valid Until: April 24,2015 Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN

Approved by: Ludivina D. Magpali Dean PRC I.D No. 0186484 Valid Until: August 5, 2012 Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN

ODC Form 1B ASSISTED DELIVERY FORM

LORMA COLLEGES Carlatan, City of San Fernando, La Union (072) 700-2500, Fax Number 242-3628, Lorma.org (ACSCU-AAI Level III RE-ACCREDITED STATUS valid until April 2012)

ACTUAL DELIVERY in Lorma Medical Center, Carlatan, City of San Fernando, La Union

Prepared by: Janry Clement Del Moral Mostoles Student

Signature of Student_________________________________

Date Performed and Time Started April 20,2011 8:12 pm

Patient's INITIAL Case Number

PROCEDURE PERFORMED Assisted Delivery Normal Spontaneous Delivery ( with Right Mediolateral Episiotomy )

D.R. Nurse on Duty

SUPERVISED BY

A.R.L 0322588

___________________________ Yolanda K. Gayyed, RN

_______________________________ Jonalyn Padilla, RN, MAN (Thesis Writing I)

Noted by: Honesto G. Alnas Clinical Coordinator PRC I.D No. 0248316 Valid Until: April 24,2015 Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN

Approved by: Ludivina D. Magpali Dean PRC I.D No. 0186484 Valid Until: August 5, 2012 Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN

ODC Form 1C CORD CARE FORM

LORMA COLLEGES Carlatan, City of San Fernando, La Union (072) 700-2500, Fax Number 242-3628, Lorma.org (ACSCU-AAI Level III RE-ACCREDITED STATUS valid until April 2012)

IMMEDIATE NEWBORN CORD CARE in Lorma Medical Center, Carlatan, City of San Fernando, La Union Prepared by:Ocaoi Maverick Taganap Student Date Performed and Time Started February 10,2012 8:25 am Patient's INITIAL Case Number O.G.D. 364206 Immediate Newborn Cord Care PERFORMED (Where Performed) Delivery Room Nurse on Duty SUPERVISED BY Signature of Student __________________________________

___________________________ Mark G. Sison, RN

____________________________ Jonalyn Padilla, RN,MAN (Thesis Writing I)

February 03,2012 10:50 am

A.S.B. 363608

Delivery Room

___________________________ Rodel T. Novales, RN

____________________________ Jonalyn Padilla, RN,MAN (Thesis Writing I)

Noted by: Honesto G. Alnas Clinical Coordinator PRC I.D No. 0248316 Valid Until: April 24,2015 Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN

Approved by: Ludivina D. Magpali Dean PRC I.D No. 0186484 Valid Until: August 5, 2012 Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN

ODC Form 1C CORD CARE FORM

LORMA COLLEGES Carlatan, City of San Fernando, La Union (072) 700-2500, Fax Number 242-3628, Lorma.org (ACSCU-AAI Level III RE-ACCREDITED STATUS valid until April 2012)

IMMEDIATE NEWBORN CORD CARE in Lorma Medical Center, Carlatan, City of San Fernando La Union

Prepared by:Ocaoi Maverick Taganap Student Date Performed and Time Started December 15,2011 8:10 pm Patient's INITIAL Case Number R.G.M. 560536

Signature of Student __________________________________

Immediate Newborn Cord Care PERFORMED (Where Performed) Delivery Room

Nurse on Duty

SUPERVISED BY

___________________________ Ma. Cecilia H. Galon , RN

____________________________ Fe M. Nisperos, RN, MAN (Thesis Writing II)

Noted by: Honesto G. Alnas Clinical Coordinator PRC I.D No. 0248316 Valid Until: April 24,2015 Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN

Approved by: Ludivina D. Magpali Dean PRC I.D No. 0186484 Valid Until: August 5, 2012 Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN

ODC Form 2B O.R. CIRCULATING FORM

LORMA COLLEGES Carlatan, City of San Fernando, La Union

(072) 700-2500, Fax Number 242-3628, Lorma.org (ACSCU-AAI Level III RE-ACCREDITED STATUS valid until April 2012)

SURGICAL SCRUB in Ilocos Training and Regional Medical Center Parian, San Fernando City, La Union

Prepared by: Ocaoi Maverick Taganap Student Date Performed and Time Started August 23, 2011 10:05am Patient's INITIAL Case Number G.L.L. 2011- 0101804

Signature of Student ________________________________

SURGICAL PROCEDURE PERFORMED Mesh Herniorraphy, Right Hyroceolectomy Right Inguinal

O.R. Nurse on Duty

SUPERVISED BY

___________________________ Crisanti H. Alviar, RN

______________________________ Aurelio Manego, RN, MAN (Thesis Writing II)

Noted by: Honesto G. Alnas Clinical Coordinator PRC I.D No. 0248316 Valid Until: April 24,2015 Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN

Approved by: Ludivina D. Magpali Dean PRC I.D No. 0186484 Valid Until: August 5, 2012 Date document is signed:___________ Time:____________ Highest Nursing Degree Earned: MAN