Republic of the Philippines

Laguna State Polytechnic University Santa Cruz, Laguna

College of Nursing and Allied Health

ATTENDANCE

Date: ___________________________________

Shift: ____________________________________

Area: ____________________________________

Hospital: __________________________________

Name of Students Time In Time Out Signature

1._______________________ _______ _______ __________

2._______________________ _______ _______ __________

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9._______________________ _______ _______ __________

10._______________________ _______ _______ __________

11._______________________ _______ _______ __________

Clinical Instructor: ______________________________

Full Name and Signature

Republic of the Philippines

Laguna State Polytechnic University Santa Cruz, Laguna

College of Nursing and Allied Health

ATTENDANCE

Date: ___________________________________

Shift: ____________________________________

Area: ____________________________________

Hospital: __________________________________

Name of Students Time In Time Out Signature

1._______________________ _______ _______ __________

2._______________________ _______ _______ __________

3._______________________ _______ _______ __________

4._______________________ _______ _______ __________

5._______________________ _______ _______ __________

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7._______________________ _______ _______ __________

8._______________________ _______ _______ __________

9._______________________ _______ _______ __________

10._______________________ _______ _______ __________

11._______________________ _______ _______ __________

Clinical Instructor: ______________________________

Full Name and Signature

Republic of the Philippines

Laguna State Polytechnic University Santa Cruz, Laguna

College of Nursing and Allied Health

ATTENDANCE

Date: ___________________________________

Shift: ____________________________________

Area: ____________________________________

Hospital: __________________________________

Name of Students Time In Time Out Signature

1._______________________ _______ _______ __________

2._______________________ _______ _______ __________

3._______________________ _______ _______ __________

4._______________________ _______ _______ __________

5._______________________ _______ _______ __________

6._______________________ _______ _______ __________

7._______________________ _______ _______ __________

8._______________________ _______ _______ __________

9._______________________ _______ _______ __________

10._______________________ _______ _______ __________

11._______________________ _______ _______ __________

Clinical Instructor: ______________________________

Full Name and Signature

Republic of the Philippines

Laguna State Polytechnic University Santa Cruz, Laguna

College of Nursing and Allied Health

ATTENDANCE

Date: ___________________________________

Shift: ____________________________________

Area: ____________________________________

Hospital: __________________________________

Name of Students Time In Time Out Signature

1._______________________ _______ _______ __________

2._______________________ _______ _______ __________

3._______________________ _______ _______ __________

4._______________________ _______ _______ __________

5._______________________ _______ _______ __________

6._______________________ _______ _______ __________

7._______________________ _______ _______ __________

8._______________________ _______ _______ __________

9._______________________ _______ _______ __________

10._______________________ _______ _______ __________

11._______________________ _______ _______ __________

Clinical Instructor: ______________________________

Full Name and Signature