Beruflich Dokumente
Kultur Dokumente
ARELLANO UNIVERSITY
Jose Abad Santos Campus
3058 Taft Avenue, Pasay City, Philippines 1300
Tel Nos: 832-2446; 832-5525; 831-8077 Loc 101-116
Telefax:833-4728
PROCEDURE
PERFORMED
Case Number
(not applicable for birthing/
SUPERVISED BY
Clinical Instructor
Name and Signature
Lying-In Clinics/Homes)
(STRICTLY NO DESIGNATES)
ODC Form 1B
Assisted Delivery
Form
ARELLANO UNIVERSITY
Jose Abad Santos Campus
3058 Taft Avenue, Pasay City, Philippines 1300
Tel Nos: 832-2446; 832-5525; 831-8077 Loc 101-116
Telefax:833-4728
PROCEDURE
PERFORMED
Case Number
(not applicable for birthing/
Lying-In Clinics/Homes)
SUPERVISED BY
Clinical Instructor
Name and Signature
ASSISTED DELIVERY
(STRICTLY NO DESIGNATES)
ODC Form 1C
Cord Care Form
ARELLANO UNIVERSITY
Jose Abad Santos Campus
3058 Taft Avenue, Pasay City, Philippines 1300
Tel Nos: 832-2446; 832-5525; 831-8077 Loc 101-116
Telefax:833-4728
IMMEDIATE NEWBORN CORD CARE in OSPITAL NG MAYNILA MEDICAL CENTER, MALATE MANILA
Hospital/Home/Lying-In Clinic, Municipality/City/Province
Prepared by:
Printed name and Signature of Student: CELESTINO, KEVIN JAN B.
Date performed
and
Time Started
Nurse On Duty
(Name and Signature)
(If Midwife on Duty,
Signature not Required)
SUPERVISED BY
Clinical Instructor
Name and Signature
Mariciena Amor C.
Merino R.N.
Rosechelle S.
Elarco R.N. M.A.N.
Mariciena Amor C.
Merino R.N.
Rosechelle S.
Elarco R.N. M.A.N.
Mariciena Amor C.
Merino R.N.
Rosechelle S.
Elarco R.N. M.A.N.
Lying-In Clinics/Homes)
BABY GIRL P.
8:55 pm
690423
BABY GIRL A.
9:40 pm
690425
BABY GIRL D.
2:58 AM
690427
Level IV Chairman, PRC I.D No.: 0115934Valid Until: August 20, 2015
Date document is signed:________________ Time: ___________
Highest Nursing Degree Earned: B.S.N, M.A.N, E.d.D.
(STRICTLY NO DESIGNATES)
ODC Form 2B
Cord Care Form
ARELLANO UNIVERSITY
Jose Abad Santos Campus
3058 Taft Avenue, Pasay City, Philippines 1300
Tel Nos: 832-2446; 832-5525; 831-8077 Loc 101-116
Telefax:833-4728
B.D.S
2:00 pm
2733039
R.A.F.D
3:30 pm
1748990
SURGICAL PROCEDURE
PERFORMED
SUPERVISED BY
Clinical Instructor
Name and Signature
Hernioplasty, Right
Christian Lloyd M.
Cabusay R.N.
Arleen E. Monterde
R.N., M.A.N.
Christian Lloyd M.
Cabusay R.N.
Arleen E. Monterde
R.N., M.A.N.
Case Number
Level IV Chairman, PRC I.D No.: 0115934Valid Until: August 20, 2015
Date document is signed:________________ Time: ___________
Highest Nursing Degree Earned: B.S.N, M.A.N, E.d.D.
(STRICTLY NO DESIGNATES)
ODC Form 2B
Cord Care Form
ARELLANO UNIVERSITY
Jose Abad Santos Campus
3058 Taft Avenue, Pasay City, Philippines 1300
Tel Nos: 832-2446; 832-5525; 831-8077 Loc 101-116
Telefax:833-4728
J.H.M.A
6:40pm
2731727
C.P.C
2 pm
2733977
SURGICAL PROCEDURE
PERFORMED
SUPERVISED BY
Clinical Instructor
Name and Signature
Christian Lloyd M.
Cabusay R.N.
Arleen E. Monterde
R.N. M.A.N.
Thoracentesis
Christian Lloyd M.
Cabusay R.N.
Arleen E. Monterde
R.N. M.A.N.
Case Number
Level IV Chairman, PRC I.D No.: 0115934Valid Until: August 20, 2015
Date document is signed:________________ Time: ___________
Highest Nursing Degree Earned: B.S.N, M.A.N, E.d.D.
(STRICTLY NO DESIGNATES)