joan scrubs

8/8/2019 Joan Scrubs

1/19

WEST NEGROS UNIVERSITY(Formerly WEST NEGROS COLLEGE) SPECIFIED FORMS & SCRUBSCOLLEGE OF NURSING As per PRC Resolution No. 357 Series 2004Burgos St., Bacolod City and PRC-BON Memorandum No. 01, S.2008

Name of Student: HERMOSO, JOAN C.. First Course (if any): ______________________________ Year: _________Date of School Program was Recognized: ____Effective_SY 1995 - 1996_______________ School Graduated from: West Negros UniversityAccreditation Level: _________________________________________________________ Year of Admission in the BSN Program: 2002

Year Graduated from the BSN Program: 2010

I. MAJOR SCRUBS

No.TimeStarted

TimeEnded

Date ofOperation

CaseNo.

Name of PatientOperationPerformed

Type of Anesthesia Name of Surgeon Name of Hospit

1 11:20Am 12:45pm Novemb

er 26,2009

15348 Renayong, Norlia Primary LowTransverse

Caesarian Section

Spinal Henrietta Lucasan The DoctorsHospital

Incorporated

Prepared by: Supervised by: Noted by: Concurred by: Approved by:

JOAN C. HERMOSO BELLE PAPARON MA. LOURDES B. MAGBANUA EDITA BAYONETA HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _ ____________ Date Signed__________________ Date Signed: _ ____________ Date Signed: _ ________Date: February 25, 2010 Degree: RN, MN Degree: RM, RN, RT, MAN, Ph. D Degree: CN, RN, MN Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.: 0086493 a) PRC No.: 0157222 a) PRC No.: 0125661 a) PRC No.: 0056974

Valid Until: August 22, 2010 Valid Until: September 21, 2010 Valid Until: August 08, 2012 Valid Until:November 15, 2011

b) PNA No.: 10553 b) PNA No.: 9706 b) PNA No.: 19677 b) PNA No.: 045219

Valid Until: Lifetime Valid Until: Lifetime Valid Until: Lifetime ValidOctober 31, 2010


2/19


Name of Student: HERMOSO, JOAN C. First Course (if any): ______________________________ Year: _________Date of School Program was Recognized: ____Effective_SY 1995 - 1996_______________ School Graduated from: West Negros UniversityAccreditation Level: _________________________________________________________ Year of Admission in the BSN Program: 2002


I. MAJOR SCRUBS

No.TimeStarted

TimeEnded

Date ofOperation

CaseNo.



2 11:35am 1:25pm January 3, 2010 10-005 Barrios, Reynald ExploratoryLaparotomy;Evacuation of

massiveHemoperitonium;Jejunorrhaphy;Copious Lavage;

Drain

GeneralEndotrachealAnesthesia

Jose Libo-on III Teresita LopezJalandoni Provinc

Hospital


JOAN C. HERMOSO RAFAEL MARMOLEJO MA. LOURDES B. MAGBANUA MA. TERESA O. SEVERINO HELEN V. CORNAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _ ____________ Date Signed__________________ Date Signed: _ ____________ Date Signed: _ ________Date: February 25, 2010 Degree: RN Degree: RM, RN, RT, MAN, Ph. D Degree: RN, MN Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.: 0260390 a) PRC No.: 0157222 a) PRC No.: 0101938 a) PRC No.: 0056974

Valid Until: June 27, 2010 Valid Until: September 21, 2010 Valid Until: April 27, 2011 Valid Until:November 15, 2011

b) PNA No.: 045285 b) PNA No.: 9706 b) PNA No.: 17418 b) PNA No.: 045219


3/19

Valid Until: October 31, 2010 Valid Until: Lifetime Valid Until: Lifetime Valid Until:October 31, 2010


Name of Student: HERMOSO, JOAN C.. First Course (if any): ______________________________ Year: _________Date of School Program was Recognized: ____Effective_SY 1995 - 1996_______________ School Graduated from: West Negros UniversityAccreditation Level: _________________________________________________________ Year of Admission in the BSN Program: 2002


I. MAJOR SCRUBS

No.

Time

Started

Time

Ended

Date of

Operation

Case

No. Name of Patient

Operation

Performed Type of Anesthesia Name of Surgeon Name of Hospit3 7:05am 8:15am January 17,

2010011527

34Millana, Mary Appendectomy,

Pelvic LaparotomySalpingo

Oophorectomy

GeneralEndotrachealAnesthesia

Morata Exmundo Corazon LocsiMontelibano

Memorial RegionHospital


JOAN C. HERMOSO ALBIE L. DUMASIS MA. LOURDES B. MAGBANUA JORESLYN P. BALA-AN HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _ ____________ Date Signed__________________ Date Signed: _ ____________ Date Signed: _ ________

Date: February 25, 2010 Degree: RN Degree: RM, RN, RT, MAN, Ph. D Degree: RN, MN, Ed D Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.: 0367755 a) PRC No.: 0157222 a) PRC No.: 0091019 a) PRC No.: 0056974

Val id Unti l: Apri l 15, 2011 Val id Until : September 21, 2010 Val id Unti l: May 24, 2011 Valid Until :November 15, 2011

b) PNA No.: 021547 b) PNA No.: 9706 b) PNA No.: 03079 b) PNA No.: 045219Valid Until: October 31, 2010 Valid Until: Lifetime Valid Until: Lifetime Valid Until:

October 31, 2010


4/19

WEST NEGROS UNIVERSITY(Formerly WEST NEGROS COLLEGE) SPECIFIED FORMS & SCRUBS

COLLEGE OF NURSING As per PRC Resolution No. 357 Series 2004Burgos St., Bacolod City and PRC-BON Memorandum No. 01, S.2008



I. MAJOR SCRUBS

No. TimeStarted TimeEnded Date ofOperation CaseNo. Name of Patient OperationPerformed Type of Anesthesia Name of Surgeon Name of Hospit

4 8:15am 10:10am March 10, 2010 01216091

Javellana, Louela TotalThyroidectomy with

RecurrentLaryngeal Nerve

Preservation

General Marie Manganti Corazon LocsiMontelibano


5 1:10pm 3:05pm March

10, 2010 01217621

Rotas, Kim Outer Dental Orif-Mandibular

Maxillary Fixation

General Chad Hilado Corazon LocsiMontelibano



JOAN C. HERMOSO TRINA PANTALEON MA. LOURDES B. MAGBANUA JORESLYN P. BALA-AN HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _ ____________ Date Signed__________________ Date Signed: _ ____________ Date Signed: _ ________Date: February 25, 2010 Degree: RN Degree: RM, RN, RT, MAN, Ph. D Degree: RN, MN, Ed D Degree: RN, MN, Ed D


5/19

Place: Bacolod City a) PRC No.: 0461440 a) PRC No.: 0157222 a) PRC No.: 0091019 a) PRC No.: 0056974Valid Until: March 22, 2013 Valid Until: September 21, 2010 Valid Until: May 24, 2011 Valid Until:

November 15, 2011b) PNA No.: 044577 b) PNA No.: 9706 b) PNA No.: 03079 b) PNA No.: 045219



Name of Student: HERMOSO, JOAN C. First Course (if any): ______________________________ Year: ___________Date of School Program was Recognized: ____Effective_SY 1995 - 1996_______________ School Graduated from: West Negros UniversityAccreditation Level: _________________________________________________________ Year of Admission in the BSN Program: 2002


II. MINOR SCRUBS

No.TimeStarted

TimeEnded

Date ofOperation

CaseNo.



1 7:30pm 7:45pm May 23, 2009 41591 Lamis, Loreto Suturing WoundLeft Forehead

Local Jose Libo-on III Teresita LopezJalandoni Provinc

Hospital


JOAN C. HERMOSO FERRER T. GO MA. LOURDES B. MAGBANUA MA. TERESA O. SEVERINO HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _____________ Date Signed__________________ Date Signed: _____________ Date Signed: _________Date: February 25, 2010 Degree: RN Degree: RM, RN, RT, MAN, Ph. D Degree: RN, MN Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.: 0378916 a) PRC No.: 0157222 a) PRC No.: 0101938 a) PRC No.: 0056974

Valid Until: December 21, 2011 Valid Until: September 21, 2010 Valid Until: April 27, 2011 Valid Until: Novemb15, 2011


6/19

b) PNA No.: 021555 b) PNA No.: 9706 b) PNA No.: 17418 b) PNA No.: 045219Valid Until: _October 31, 2010 Valid Until: Lifetime Valid Until: Lifetime Valid Until:

October 31, 2010


Name of Student: HERMOSO, JOAN C. First Course (if any): ______________________________ Year: ___________Date of School Program was Recognized: ____Effective_SY 1995 - 1996_______________ School Graduated from: West Negros University

Accreditation Level: _________________________________________________________ Year of Admission in the BSN Program: 2002Year Graduated from the BSN Program: 2010

II. MINOR SCRUBS

No.TimeStarted

TimeEnded

Date ofOperation

CaseNo.



2 1:55PM 2:00PM June 29, 2009 01119006

Pulao, Juditha CompletionCurettage

IntravenousSedation

April Gentugaya Corazon LocsiMontelebano



JOAN C. HERMOSO ROSELYN D. GERIA MA. LOURDES B. MAGBANUA JORESLYN P. BALA-AN HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _____________ Date Signed__________________ Date Signed: _____________ Date Signed: _________


7/19

Date: February 25, 2010 Degree: RN, MN Degree: RM, RN, RT, MAN, Ph. D Degree: RN, MN, Ed D Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.: 01434420 a) PRC No.: 0157222 a) PRC No.: 0091019 a) PRC No.: 0056974

Valid Until: May 13, 2011 Valid Until: September 21, 2010 Valid Until: May 24, 2011 Valid Until:November 15, 2011

b) PNA No.: 012541 b) PNA No.: 9706 b) PNA No.: 03079 b) PNA No.: 045219Valid Until: December 31, 2009 Valid Until: Lifetime Valid Until: Lifetime Valid Until:

October 31, 2010




II. MINOR SCRUBS

No.TimeStarted

TimeEnded

Date ofOperation

CaseNo.



3 3:20am 3:25am January 28,2010

01154620

Linco, FrancelleRillane

Close Reduction;Application of LongArm Posterior Mold,

Right

IntravenousSedation

Ian Villar Corazon LocsiMontelibano



JOAN C. HERMOSO MARILYN P. ORTALIZ MA. LOURDES B. MAGBANUA JORESLYN P. BALA-AN HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _____________ Date Signed__________________ Date Signed: _____________ Date Signed: _________


8/19

Date: February 25, 2010 Degree: RN, MAN Degree: RM, RN, RT, MAN, Ph. D Degree: RN, MN, Ed D Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.: 0337642 a) PRC No.: 0157222 a) PRC No.: 0091019 a) PRC No.: 0056974

Valid Until: November 6, 2013 Valid Until: September 21, 2010 Valid Until: May 24, 2011 Valid Until: Novemb15, 2011

b) PNA No.: 045719 b) PNA No.: 9706 b) PNA No.: 03079 b) PNA No.: 045219Valid Until: _October 31, 2010 Valid Until: Lifetime Valid Until: Lifetime Valid Until:

October 31, 2010




II. MINOR SCRUBS

No.TimeStarted

TimeEnded

Date ofOperation

CaseNo.



4 3:30pm 3:40pm 01156837

Galdo, Niko Suturing of Wound Local Gladys Pailano Corazon LocsiMontelibano



JOAN C. HERMOSO CLAIRE CASTRO MA. LOURDES B. MAGBANUA JORESLYN P. BALA-AN HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _____________ Date Signed__________________ Date Signed: _____________ Date Signed: _________


9/19

Date: February 25, 2010 Degree: RN, MN Degree: RM, RN, RT, MAN, Ph. D Degree: RN, MN, Ed. D Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.: a) PRC No.: 0157222 a) PRC No.: 0091019 a) PRC No.: 0056974

Valid Until: Valid Until: September 21, 2010 Valid Until: May 24, 2011 Valid Until:November 15, 2011

b) PNA No.: _____________ b) PNA No.: 9706 b) PNA No.: 03079 b) PNA No.: 045219Valid Until: ____________ Valid Until: Lifetime Valid Until: Lifetime Valid Until:

October 31, 2010


Name of Student: HERMOSO, JOAN C. First Course (if any): ______________________________ Year: ___________Date of School Program was Recognized: ____Effective_SY 1995 - 1996_______________ School Graduated from: West Negros UniversityAccreditation Level: _________________________________________________________ Year of Admission in the BSN Program: 2002


II. MINOR SCRUBS

No.TimeStarted

TimeEnded

Date ofOperation

CaseNo.



5


JOAN C. HERMOSO CLAIRE CASTRO MA. LOURDES B. MAGBANUA JORESLYN P. BALA-AN HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEAN


10/19

CTC Number: 06387976 Date Signed: _____________ Date Signed__________________ Date Signed: _____________ Date Signed: _________Date: February 25, 2010 Degree: RN, MN Degree: RM, RN, RT, MAN, Ph. D Degree: RN, MN, Ed. D Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.: 0337642 a) PRC No.: 0157222 a) PRC No.: 0091019 a) PRC No.: 0056974


b) PNA No.: _____________ b) PNA No.: 9706 b) PNA No.: 03079 b) PNA No.: 045219Valid Until: ____________ Valid Until: Lifetime Valid Until: Lifetime Valid Until:

October 31, 2010


Name of Student: HERMOSO, JOAN C. First Course (if any): ______________________________ Year: _________

Date of School Program was Recognized: ____Effective_SY 1995 - 1996_______________ School Graduated from: West Negros UniversityAccreditation Level: _________________________________________________________ Year of Admission in the BSN Program: 2002


III. ACTUAL DELIVERIES

No.CaseNo.

Diagnosis Name of Mother AgeDate ofDelivery

Time ofDelivery

Gender of Baby Name of Hospital Type of Deliver

1 01119476

Pregnancy UterineFull Term Gravida 3

Para 3

Deocares, Nenita 35 June 29,2009

12:14 pm Male Corazon LocsinMontelibano

Memorial RegionalHospital

NormalSpontaneous

Vaginal Deliver


JOAN C. HERMOSO ROSELYN D. GERIA MA. LOURDES B. MAGBANUA JORESLYN P. BALA-AN HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _____________ Date Signed__________________ Date Signed: _____________ Date Signed: _________


11/19

Date: February 25, 2010 Degree: RN, MN Degree: RM, RN, RT, MAN, Ph. D Degree: RN, MN, Ed D Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.: 0143420 a) PRC No.: 0157222 a) PRC No.: 0091019 a) PRC No.: 0056974

Val id Unti l: May 13, 2011 Valid Until : September 21, 2010 Val id Unti l: May 24, 2011 Valid Until :November 15, 2011

b) PNA No.: 012541 b) PNA No.: 9706 b) PNA No.: 03079 b) PNA No.: 045219Valid Until: Decembaer 21,2009 Valid Until: Lifetime Valid Until: Lifetime Valid Until:

October 31, 2010





No.CaseNo.


Time ofDelivery


2 00-00-46


Para 2

Tormis, Lily Ann 33 December11, 2009

7:58 am Male Well Family MidwifeClinic Rosario

Mabini

NormalSpontaneous

Vaginal Deliver


JOAN C. HERMOSO MA. CECILIA IGNALAGUE MA. LOURDES B. MAGBANUA HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEAN


12/19

CTC Number: 06387976 Date Signed: _____________ Date Signed__________________ Date Signed: _____________ Date Signed: _________Date: February 25, 2010 Degree: Degree: RM, RN, RT, MAN, Ph. D Degree: RN, MN, Ed D Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.: a) PRC No.: 0157222 a) PRC No.: 0091019 a) PRC No.: 0056974


b) PNA No.: b) PNA No.: 9706 b) PNA No.: 03079 b) PNA No.: 045219Valid Until: Valid Until: Lifetime Valid Until: Lifetime Valid

October 31, 2010


Name of Student: HERMOSO, JOAN C. First Course (if any): ______________________________ Year: _________

Date of School Program was Recognized: ____Effective_SY 1995 - 1996_______________ School Graduated from: West Negros UniversityAccreditation Level: _________________________________________________________ Year of Admission in the BSN Program: 2002Year Graduated from the BSN Program: 2010


No. Case No. Diagnosis Name of Mother AgeDate ofDelivery

Time ofDelivery


3 01162070


Para 5

Cordero. Jocelyn 35 March 15,2010

2:18 pm Female Corazon LocsinMontelibano


NormalSpontaneous

Vaginal Deliver

4 01161890


Para 3

Bayles, Dorina 31 March 15,2010

5:36 pm Male Corazon LocsinMontelibano


NormalSpontaneous

Vaginal Deliver

5 001164031


Para 1

Angeles, Jennifer 20 March 28,2010

2:12 pm Female Corazon LocsinMontelibano


NormalSpontaneous

Vaginal Deliver


13/19


JOAN C. HERMOSO MOLY V. CALAMAY MA. LOURDES B. MAGBANUA JORESLYN P. BALA-AN HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _____________ Date Signed__________________ Date Signed: _____________ Date Signed: _________Date: February 25, 2010 Degree: RN Degree: RM, RN, RT, MAN, Ph. D Degree: RN, MN, Ed D Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.: 0262640 a) PRC No.: 0157222 a) PRC No.: 0091019 a) PRC No.: 0056974

Valid Until: November 6, 2012 Valid Until: September 21, 2010 Valid Until: May 24, 2011 Valid Until:






IV. ASISTED DELIVERIES

No.CaseNo.


Time ofDelivery


1 01119498


Para 4

Canlas, Sally 28 June 29,2009

11:06 am Female Corazon LocsinMontelibano


NormalSpontaneous

Vaginal Deliver



14/19

JOAN C. HERMOSO ROSELYN D. GERIA MA. LOURDES B. MAGBANUA JORESLYN P. BALA-AN HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _ ____________ Date Signed__________________ Date Signed: _ ____________ Date Signed: _ ________Date: February 25, 2010 Degree: RN, MN Degree: RM, RN, RT, MAN, Ph. D Degree: RN, MN, Ed D Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.: 0143420 a) PRC No.: 0157222 a) PRC No.: 0091019 a) PRC No.: 0056974

Valid Until: May 13, 2011 Valid Until: September 21, 2010 Valid Until: May 24, 2011 Valid Until:November 15, 2011

b) PNA No.: 012541 b) PNA No.: 9706 b) PNA No.: 03079 b) PNA No.: 045219Valid Until: December 31, 2009 Valid Until: Lifetime Valid Until: Lifetime Valid Until:

October 31, 2010




IV. ASSISTED DELIVERIES

No. Case No. Diagnosis Name of Mother AgeDate ofDelivery

Time ofDelivery


2 0900030

74

Pregnancy Uterine

Full Term Gravida 2Para 2

Cruz, Divina dela 27 July 23,

2009

1:00 am Baby Boy Normal

SpontaneousVaginal Delivery

3 090003080


Para 2

Medina, Margarette 25 July 23,2009

05:20 am Baby Girl NormalSpontaneousVaginal Delivery


15/19


JOAN C. HERMOSO MA. CHERRYL C. GENERALES MA. LOURDES B. MAGBANUA HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _____________ Date Signed__________________ Date Signed: _____________ Date Signed: _________Date: February 25, 2010 Degree: RN, MN Degree: RM, RN, RT, MAN, Ph. D Degree: Degree: RN, MN, Ed D

Place: Bacolod City a) PRC No.: a) PRC No.: 0157222 a) PRC No.: a) PRC No.: 0056974Valid Until: Valid Until: September 21, 2010 Valid Until: Valid Until:

November 15, 2011b) PNA No.: b) PNA No.: 9706 b) PNA No.: 03079 b) PNA No.: 045219

Valid Until: Valid Until: Lifetime Valid Until: Lifetime ValidOctober 31, 2010

WEST NEGROS UNIVERSITY(Formerly WEST NEGROS COLLEGE) SPECIFIED FORMS & SCRUBS

COLLEGE OF NURSING As per PRC Resolution No. 357 Series 2004Burgos St., Bacolod City and PRC-BON Memorandum No. 01, S.2008




No. CaseNo.

Diagnosis Name of Mother Age Date ofDelivery

Time ofDelivery


4 09-3593 Pregnancy Uterine FullTerm Gravida 11 Para

11

Quianola, Mary Ann 33 August 24,2009

7:18 pm Female Teresita LopezJalandoni Provincial

Hospital

NormalSpontaneous

Vaginal Deliver


16/19


JOAN C. HERMOSO RUTCHEL M. MONDIA MA. LOURDES B. MAGBANUA MA. TERESA O. SEVERINO HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _____________ Date Signed__________________ Date Signed: _____________ Date Signed: _________Date: February 25, 2010 Degree: RN, MN Degree: RM, RN, RT, MAN, Ph. D Degree: RN, MN Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.: a) PRC No.: 0157222 a) PRC No.: 0101938 a) PRC No.: 0056974

Valid Until: Valid Until: September 21, 2010 Valid Until: July 11, 2011 Valid Until: Novemb

15, 2011b) PNA No.: b) PNA No.: 9706 b) PNA No.: 17418 b) PNA No.: 045219

Valid Until: Valid Until: Lifetime Valid Until: Lifetime ValidOctober 31, 2010





No. CaseNo.

Diagnosis Name of Mother Age Date ofDelivery

Time ofDelivery


5 28032 Gravida 3 Para 3 Malacon, Gina 40 March 6,2010

9:47 am Male The DoctorsHospital

Incorporated

NormalSpontaneous

Vaginal Deliver


17/19


JOAN C. HERMOSO MOLY V. CALAMAY MA. LOURDES B. MAGBANUA EDITA BAYONETA HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _____________ Date Signed__________________ Date Signed: _____________ Date Signed: _________Date: February 25, 2010 Degree: RN, Degree: RM, RN, RT , MAN, Ph. D Degree: CN, RN, MN Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.: 0262640 a) PRC No.: 0157222 a) PRC No.: 0125661 a) PRC No.: 0056974

Valid Until: November 6, 2012 Valid Until: September 21, 2010 Valid Until: August 8, 2012 Valid Until:



WEST NEGROS UNIVERSITY(Formerly WEST NEGROS COLLEGE) SPECIFIED FORMS & SCRUBSCOLLEGE OF NURSING As per PRC Resolution No. 357 Series 2004

Burgos St., Bacolod City and PRC-BON Memorandum No. 01, S.2008

Name of Student: HERMOSO JOAN C. First Course (if any): ______________________________ Year: _________Date of School Program was Recognized: ____Effective_SY 1995 - 1996_______________ School Graduated from: West Negros UniversityAccreditation Level: _________________________________________________________ Year of Admission in the BSN Program: 2002


V. CORD DRESSING

No.Case

No.

Date Performed Time of Delivery Gender of Baby Name of Mother Age Name of Hospital

1 09-6422 November 27, 2009 7:15 am Male Gamboa, Joy 31 Teresita Lopez JalandoniProvincial Hospital

2 09-6426 November 27, 2009 12:29 pm Male Gilotin, Meriam 32 Teresita Lopez JalandoniProvincial Hospital

3 09-6431 November 27,2009 3:39 pm Female Natabio, Ma. Jinky Teresita Lopez JalandoniProvincial Hospital


18/19


JOAN C. HERMOSO HELEN A. PO MA. LOURDES B. MAGBANUA MA. TERESA O.SEVERINO HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _____________ Date Signed__________________ Date Signed: _____________ Date Signed: _________Date: February 25, 2010 Degree: RN Degree: RM, RN, RT, MAN, Ph. D Degree: RN, MN Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.:0052508 a) PRC No.: 0157222 a) PRC No.: 0101938 a) PRC No.: 0056974

Valid Until: December 28, 2011 Valid Until: September 21, 2010 Valid Until: Aril 27. 2011 Valid Until: Novemb15, 2011

b) PNA No.: 032431 b) PNA No.: 9706 b) PNA No.: 17418 b) PNA No.: 045219Valid Until: October 31, 2010 Valid Until: Lifetime Valid Until: Lifetime Valid

October 31, 2010


Name of Student: HERMOSO JOAN C. First Course (if any): ______________________________ Year: _________Date of School Program was Recognized: ____Effective_SY 1995 - 1996_______________ School Graduated from: West Negros UniversityAccreditation Level: _________________________________________________________ Year of Admission in the BSN Program: 2002


V. CORD DRESSING

No.CaseNo.

Date Performed Time of Delivery Gender of Baby Name of Mother Age Name of Hospital

4 09-300 November 29, 2009 8:45 am Male Villamero, Veronica 29 Dr. Jose C. Locsin MemorialMaternity Clinic

5 09-301 November 29, 2009 3:08 pm Female Piamonte, Roxanne 18Dr. Jose C. Locsin Memorial

Maternity Clinic


19/19


JOAN C. HERMOSO MARICAR BEGASA MA. LOURDES B. MAGBANUA MA. TERESA O.SEVERINO HELEN V. CORREANAME OF EXAMINEE CLINICAL INSTRUCTOR CLINICAL COORDINATOR CHIEF NURSE DEANCTC Number: 06387976 Date Signed: _____________ Date Signed__________________ Date Signed: _____________ Date Signed: _________Date: February 25, 2010 Degree: RN Degree: RM, RN, RT, MAN, Ph. D Degree: RN, MN Degree: RN, MN, Ed DPlace: Bacolod City a) PRC No.: a) PRC No.: 0157222 a) PRC No.: 0101938 a) PRC No.: 0056974

Valid Until: Valid Until: September 21, 2010 Valid Until: Aril 27. 2011 Valid Until: Novemb15, 2011

b) PNA No.: b) PNA No.: 9706 b) PNA No.: 17418 b) PNA No.: 045219Valid Until: Valid Until: Lifetime Valid Until: Lifetime Valid

October 31, 2010

joan scrubs

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