My PRC Final Exhibit Form

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Tigatto Road, Buhangin, Davao City, Philippines
IP P IN E
Tel Nos: (082) 241-1350, 241-1356
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Fax No.: (082) 241-1351
Name of Student: ELDEN JOY TAYABAS CUBERO____________________________________________________

Name & Address of School: DMMA College of Southern Philippines Tigatto Road, Buhangin, Davao City, Philippines
Accredited Level: Not applicable Year Granted: Not applicable____________________________________________
Date School/Program was Recognized: July 23, 2007 Number: 019 Year: 2007______________________________
First Course: Not applicable School Graduated: Not applicable Year: Not applicable__________________________
Year of Admission in the Bachelor of Science in Nursing Program: 2006___________________________________
Year Graduated (BSN Program): 2010_______________________________________________________________
MINOR SCRUBS
No. Date of Case No. Name of Patient Diagnosis Operation Performed Type of Anesthesia Name of Surgeon Name of Hospital Name of OR Scrub Name and Signature of
Operation Nurse Qualified Clinical Instructor
01 January 27, 110093 Jeff Cosmeño Lacerated Suturing Local Anesthesia Dr. Cuñado Medical Mission Group Darwin Cariño, R.N. Vanessa April T. Prantilla
2009 wound right Hospital & Health RN, MN
eyebrow Services Cooperative of
Tagum
Prepared by:
ELDEN JOY TAYABAS CUBERO

Signature over printed name of applicant
Noted by: Concurred by: Approved by:

HILLARI BIANCA L. EUSEBIO, RN, MN___ JUAN G. PANUNCIO, BSN, RN____________ LUDIVINA S. ALEJANDRE, RN, MaED, MAN
Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse
Date Signed:_____________________________ Signature over printed name of Dean of Nursing
Date Signed: _____________________________ Date Signed: _____________________________
Degree: Master in Nursing_________________
Degree: Bachelor of Science in Nursing__ __ Degree: Master of Arts in Nursing_________
a). PRC No.: 0368845______________________
Valid Until: January 28, 2011____________
a). PRC No.: 0155974______________________ a). PRC No.: 0079838_____________________
b). PNA No. : 055100______________________ Valid Until: April 3, 2011 __________________ Valid Until: June 2, 2012__________________
Valid Until: October 31, 2010_______________ b). PNA No.:18893________________________ b). PNA No.: 055099_____________________
Valid Until: Lifetime Member_______________ Valid Until: October 31, 2010______________
c.) ANSAP No.: 01609____________________ ADPCN No.: 0827_______________________
Valid Until: December 31, 2010_____________ Valid Until: December, 2010_______________
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Tel Nos: (082) 241-1350, 241-1356
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Fax No.: (082) 241-1351
Name of Student: ELDEN JOY TAYABAS CUBERO ___________________________________________________

MINOR SCRUBS
No. Date of Case No. Name of Patient Diagnosis Operation Type of Anesthesia Name of Surgeon Name of Hospital Name of OR Scrub Name and Signature of
Operation Performed Nurse Qualified Clinical
Instructor
02 February 2072 Leonardo Siasy Suturing Laceration at Local Anesthesia Dr. Perfecto Davao Adventist Hospital Garth Plandes, R.N. Alberto S. Alejandre,
28, 2009 scalp area Llaguno, MD II, R.N.
03 April 12, 0003 Alexis Cuajao Phimosis Circumcision Local Anesthesia Dr. Perfecto Davao Adventist Hospital Sheikh Clarence Alberto S. Alejandre,
2009 Llaguno, MD Ortuoste, R.N. II, R.N.
04 April 12, 0004 Jake Pepito Non-Phimosis Circumcision Local Anesthesia Dr. Perfecto Davao Adventist Hospital Sheikh Clarence Alberto S. Alejandre,
05 April 12, 0052 Juvy Cabrera Sebaceous Cyst Exision of Cyst Local Anesthesia Dr. Perfecto Davao Adventist Hospital Sheikh Clarence Alberto S. Alejandre,
Prepared by:

Signature over printed name of applicant Concurred by: Approved by:
Noted by:
MERLYN L. GERSAVA RN, MAN_____ LUDIVINA S. ALEJANDRE, RN, MaED, MAN
HILLARI BIANCA L. EUSEBIO, RN, MN_____ Signature over printed name of Chief Nurse Signature over printed name of Dean of Nursing
Date Signed: ________________________ Date Signed: _____________________________
Signature over printed name of Clinical Coordinator
Degree: Masters of Arts in Nursing_____ Degree: Master of Arts in Nursing__________
Date Signed:_______________________________
a). PRC No.: 0123405________________ a). PRC No.: 0079838_____________________
Degree: Master in Nursing___________________
Valid Until: July 7, 2011______________ Valid Until: June 2, 2012__________________
a). PRC No.: 0368845_______________________
b). PNA No.: 019488_________________ b). PNA No.: 055099_____________________
Valid Until: January 28, 2011_________________
Valid Until: October 31, 2010__________ Valid Until: October 31, 2010______________
b). PNA No. : 055100_______________________
c.) ANSAP No.: 0354________________ ADPCN No.: 0827_______________________
Valid Until: October 31, 2010________________
Valid Until: Lifetime member__________ Valid Until: December, 2010_______________
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Tel Nos: (082) 241-1350, 241-1356
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MAJOR SCRUBS
No. Date of Case No. Name of Patient Diagnosis Operation Performed Type of Name of Surgeon Name of Hospital Name of OR Scrub Name and Signature of
Operation Anesthesia Nurse Qualified Clinical
Instructor
01 February 2, 110219 Estelita Lagumbay Repeat Caesarian Low Transverse Cesarean Sub Arachnoid Dr. Sigrid Balingit, Medical Mission Group Hospital Ariel Bunquin, RN Vanessa April T.
2009 Delivery to an Alive Section2 Block M.D. & Health Services Cooperative Prantilla RN, MN
Baby Boy Cephalic of Tagum
Gravida 2 Para 2
(2002) Apgar Score
8-10-10 Body
Weight 3.2
Kilograms
02 February 110424 Joel Durban Encarcerated wound Debridement; Wound Sub Arachnoid Dr. Miller Alaba, M.D. Medical Mission Group Hospital Darwin Cariño, RN Vanessa April T.
11, 2009 ankle; right median exploration of Post Tibial Block & Health Services Cooperative Prantilla RN, MN
aspect; Transected Artery and Vein of Tagum
posterior tibial nerve neurorraphy
artery and vein
Prepared by:

Signature over printed name of applicant Concurred by:
Noted by: Approved by:
JUAN G. PANUNCIO, BSN, RN________

HILLARI BIANCA L. EUSEBIO, RN, MN_____ LUDIVINA S. ALEJANDRE, RN, MaED, MAN
Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse Signature over printed name of Dean of Nursing
Date Signed:_______________________________ Date Signed: _________________________ Date Signed: _____________________________
Degree: Master in Nursing___________________ Degree: Bachelor of Science in Nursing__ Degree: Master of Arts in Nursing__________
a). PRC No.: 0368845_______________________ a). PRC No.: 0155974__________________ a). PRC No.: 0079838_____________________
Valid Until: January 28, 2011_________________ Valid Until: April 3, 2011 ______________ Valid Until: June 2, 2012__________________
b). PNA No. : 055100_______________________ b). PNA No.:18893____________________ b). PNA No.: 055099_____________________
Valid Until: October 31, 2010________________ Valid Until: Lifetime Member____________ Valid Until: October 31, 2010______________
c.) ANSAP No.: 01609__________________ ADPCN No.: 0827_______________________
Valid Until: December 31, 2010___________ Valid Until: December, 2010_______________
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Tel Nos: (082) 241-1350, 241-1356
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1 9 9 3 Fax No.: (082) 241-1351
Name of Student: ELDEN JOY TAYABAS CUBERO _______________________________________________________

MAJOR SCRUBS
No. Date of Case No. Name of Patient Diagnosis Operation Performed Type of Name of Surgeon Name of Hospital Name of OR Scrub Name and Signature of
Operation Anesthesia Nurse Qualified Clinical
Instructor
03 April 21, 112038 Arlene Diaz Ovarian Cyst right Exploratory Laparotomy Sub Arachnoid Dr. Sigrid Balingit, Medical Mission Group Hospital Jazel Armilla, RN Vanessa April T.
2009 twist; pregnancy Oophorectomy Block M.D. & Health Services Cooperative Prantilla RN, MN
uterine 6-9 weeks of Tagum
Graviada 1 Para 0
05 February 7, Elanzano Low Transverse Cesarean Sub Arachnoid Dr. Sigrid Balingit, Medical Mission Group Hospital Joecel Bonane, RN Vanessa April T.
2010 Section2 Block M.D. & Health Services Cooperative Prantilla RN, MN
of Tagum
Prepared by:

Signature over printed name of applicant Concurred by:
JUAN G. PANUNCIO, BSN, RN________

Date Signed:_______________________________ Date Signed: _________________________ Date Signed: ___________________________ __
Degree: Master in Nursing___________________ Degree: Bachelor of Science in Nursing__ Degree: Master of Arts in Nursing
a). PRC No.: 0368845_______________________ a). PRC No.: 0155974__________________ a). PRC No.: 0079838
Valid Until: January 28, 2011_________________ Valid Until: April 3, 2011 ______________ Valid Until: June 2, 2012
b). PNA No. : 055100_______________________ b). PNA No.:18893____________________ b). PNA No.: 055099_____________________
Valid Until: October 31, 2010________________ Valid Until: Lifetime Member____________ Valid Until: October 31, 2010______________
c.) ANSAP No.: 01609__________________ ADPCN No.: 0827_______________________
Valid Until: December 31, 2010___________ Valid Until: December, 2010_______________
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E D M M A C O L L E G E O F SO U T H E R N P H IL IP P IN E S
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M A C O LLE
PHI
L IP P I N E
Tel Nos: (082) 241-1350, 241-1356
DM
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1 9 9 3 Fax No.: (082) 241-1351

MAJOR SCRUBS
No. Date of Case No. Name of Patient Diagnosis Operation Performed Type of Anesthesia Name of Surgeon Name of Hospital Name of OR Scrub Nurse Name and Signature of
Operation Qualified Clinical Instructor
04 February 04-32-18 Ernesta Felicida Mature Cataract Left eye Cataract Surgery Local Anesthesia Dr. Myra Grace Davao Adventist Hospital Aida M. Lamera RN Alberto S. Alejandre II,
18, 2010 Villanueva, M.D. R.N.
Prepared by:


MERLYN L. GERSAVA RN, MAN_____
Signature over printed name of Chief Nurse
Signature over printed name of Clinical Coordinator Date Signed: ________________________ Signature over printed name of Dean of Nursing
Date Signed:_______________________________ Degree: Masters of Arts in Nursing_____ Date Signed: ______________________________
Degree: Master in Nursing___________________ a). PRC No.: 0123405________________ Degree: Master of Arts in Nursing___________
a). PRC No.: 0368845_______________________ Valid Until: July 7, 2011______________ a). PRC No.: 0079838______________________
Valid Until: January 28, 2011_________________ b). PNA No.: 019488_________________ Valid Until: June 2, 2012____________________
b). PNA No. : 055100_______________________ Valid Until: October 31, 2010__________ b). PNA No.: 055099_______________________
Valid Until: October 31, 2010________________ c.) ANSAP No.: 0354________________ Valid Until: October 31, 2010________________
Valid Until: Lifetime member__________ ADPCN No.: 0827_________________________
Valid Until: December, 2010_________________
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D M M A C O L L E G E O F S O U T H E R N P H IL IP P IN E S
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P H IL
IP P IN E
Tel Nos: (082) 241-1350, 241-1356
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Fax No.: (082) 241-1351

CORD DRESSING
No. Case No. Date Performed Name of Baby Gender of Name of Mother Age Name of Hospital Name and Signature of Qualified
Baby Clinical Instructor
04 01919 December 27, 2009 Sobrino Baby Boy Male Girlie Sobrino 18 Guisok Lying -In Pamela M. Veroy RN, MAN
Prepared by:

HILLARI BIANCA L. EUSEBIO, RN, MN_____ MARCELA P. GUISOK RM__________ LUDIVINA S. ALEJANDRE, RN, MaED, MAN
Date Signed:_______________________________ Date Signed: ________________________ Date Signed: ______________________________
Degree: Master in Nursing___________________ Degree: Registered Midwife____________ Degree: Master of Arts in Nursing___________
a). PRC No.: 0368845_______________________ a). PRC No:0039514__________________ a). PRC No.: 0079838______________________
Valid Until: January 28, 2011_________________ Valid Until: June 29, 2013______________ Valid Until: June 2, 2012____________________
b). PNA No. : 055100_______________________
b). PNA No.: 055099_______________________
ADPCN No.: 0827_________________________
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Tel Nos: (082) 241-1350, 241-1356
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Fax No.: (082) 241-1351

CORD DRESSING
01 112204 April 27, 2009 Chan Baby Girl Female Chona Chan 24 Medical Mission Group Hospital Pamela M. Veroy RN, MAN
& Health Services Cooperative
of Tagum
Prepared by:

Signature over printed name of Clinical Coordinator JUAN G. PANUNCIO, BSN, RN________ Signature over printed name of Dean of Nursing
Date Signed:_______________________________ Signature over printed name of Chief Nurse Date Signed: ______________________________
Degree: Master in Nursing___________________ Date Signed: _________________________ Degree: Master of Arts in Nursing___________
a). PRC No.: 0368845_______________________ Degree: Bachelor of Science in Nursing__ a). PRC No.: 0079838______________________
Valid Until: January 28, 2011_________________ a). PRC No.: 0155974__________________ Valid Until: June 2, 2012____________________
b). PNA No. : 055100_______________________ Valid Until: April 3, 2011 ______________ b). PNA No.: 055099_______________________
b). PNA No.:18893____________________ Valid Until: October 31, 2010________________
Valid Until: Lifetime Member____________ ADPCN No.: 0827_________________________
c.) ANSAP No.: 01609__________________ Valid Until: December, 2010_________________
Valid Until: December 31, 2010___________
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Tel Nos: (082) 241-1350, 241-1356
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Fax No.: (082) 241-1351

CORD DRESSING
02 09-211 May 18,2009 Hangad Baby Girl Female Marilyn Hangad 21 La Suerte Lying -In Pamela M. Veroy RN, MAN
Prepared by:

HILLARI BIANCA L. EUSEBIO, RN, MN_____ NORMA L. ALIMPOLO , RM________ LUDIVINA S. ALEJANDRE, RN, MaED, MAN
Date Signed:_______________________________ Date Signed: _______________________ Date Signed: ______________________________
Degree: Master in Nursing___________________ Degree: Registered Midwife_ _________ Degree: Master of Arts in Nursing___________
a). PRC No.: 0368845_______________________ a). PRC No: 0042935_________________ a). PRC No.: 0079838______________________
Valid Until: January 28, 2011_________________ Valid Until: February 22, 2011__________ Valid Until: June 2, 2012____________________
b). PNA No. : 055100_______________________
b). PNA No.: 055099_______________________
ADPCN No.: 0827_________________________
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Tel Nos: (082) 241-1350, 241-1356
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Fax No.: (082) 241-1351

CORD DRESSING
03 00-00-67 July 7, 2009 Ginson Baby Boy Male Mary Ann Ginson 34 Mother’s Knows Best Alberto S. Alejandre II, R.N.
05
00-00-88 December 24, 2009 Baring Baby Girl Female Erling Mae Baring 20 Mother’s Knows Best Alberto S. Alejandre II, R.N.
Prepared by:

Approved by:
Noted by: Concurred by:
LUDIVINA S. ALEJANDRE, RN, MaED, MAN
HILLARI BIANCA L. EUSEBIO, RN, MN_____ SYLVIA P. CASTILLO, RM________
a). PRC No.: 0368845_______________________ a). PRC No: 0017468_________________ a). PRC No.: 0079838______________________
Valid Until: January 28, 2011_________________ Valid Until: February 20, 2011__________ Valid Until: June 2, 2012____________________
b). PNA No. : 055100_______________________ b). PNA No.: 055099_______________________
Valid Until: October 31, 2010________________ Valid Until: October 31, 2010________________
ADPCN No.: 0827_________________________
D M M A C O L L E G E O F SO U T H E R N P H IL IPP IN E S
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Tel Nos: (082) 241-1350, 241-1356
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DELIVERED HANDLED
No. Case No. Diagnosis Name of Mother Age Date of Delivery Time of Gender of Name of Hospital Type of Delivery Name and Signature of
Delivery Baby Qualified Clinical Instructor
Pregnancy Uterine alive baby boy

01 09-209 single by cephalic Gravida 1 Para Janice Tanduyan 26 May 18, 2009 8:53 am Male La Suerte Lying -In Normal Spontaneous Pamela M. Veroy RN, MAN
1(1001) with Apgar score-7, Head Vaginal Delivery
circumference-36cm, Chest
circumference-34cm, Length-
48cm, Weight-8.4 pounds
Prepared by:

HILLARI BIANCA L. EUSEBIO, RN, MN_____ NORMA L. ALIMPOLO , RM________ LUDIVINA S. ALEJANDRE, RN, MaED, MAN
a). PRC No.: 0368845_____________________ a). PRC No: 0042935_________________ a). PRC No.: 0079838______________________
Valid Until: January 28, 2011_________________ Valid Until: February 22, 2011__________
Valid Until: June 2, 2012____________________
b). PNA No. : 055100_______________________
b). PNA No.: 055099_______________________
ADPCN No.: 0827_________________________
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E D M M A C O L L E G E O F S O U T H E R N P H IL IP P IN E S
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IP P I N E
Tel Nos: (082) 241-1350, 241-1356
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DELIVERED HANDLED
No. Case No. Diagnosis Name of Mother Age Date of Delivery Time of Gender of Name of Hospital Type of Delivery Name and Signature of
Delivery Baby Qualified Clinical Instructor
02 00-0070 Delivered NSVD to an alive Baby Cheril Tabacon 21 July 19, 2009 2:29 pm Male Mother’s Knows Best Normal Spontaneous Alberto S. Alejandre II, R.N.
boy with an APGAR score of 8 and 9 Vaginal Delivery
Gravida 3, Parity 3
03 00-0071 Delivered NSVD to an alive Baby Gemma Ratayan 27 August 25, 2009 6:18 pm Male Mother’s Knows Best Normal Spontaneous Alberto S. Alejandre II, R.N.
boy with an APGAR score of 8 and 9 Vaginal Delivery
Gravida 3, Parity 3
04 00-0087 Delivered NSVD to an alive Baby Velinda Magracia 29 December 10, 10:02 pm Female Mother’s Knows Best Normal Spontaneous Alberto S. Alejandre II, R.N.
boy with an APGAR score of 8 and 9 2009 Vaginal Delivery
Gravida 3, Parity 3
Prepared by:

Concurred by: Approved by:

Noted by:
SYLVIA P. CASTILLO, RM________ LUDIVINA S. ALEJANDRE, RN, MaED, MAN
HILLARI BIANCA L. EUSEBIO, RN, MN_____ Signature over printed name of Dean of Nursing
Signature over printed name of Chief Nurse
Signature over printed name of Clinical Coordinator Date Signed: _______________________ Date Signed: ______________________________
Date Signed:_______________________________ Degree: Registered Midwife_ _________ Degree: Master of Arts in Nursing___________
Degree: Master in Nursing___________________ a). PRC No: 0017468_________________ a). PRC No.: 0079838______________________
a). PRC No.: 0368845_______________________ Valid Until: February 20, 2011__________ Valid Until: June 2, 2012____________________
Valid Until: January 28, 2011_________________ b). PNA No.: 055099_______________________
b). PNA No. : 055100_______________________ Valid Until: October 31, 2010________________
ADPCN No.: 0827_________________________
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E D M M A C O L L E G E O F S O U T H E R N P H IL IP P IN E S
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I P P IN E
Tel Nos: (082) 241-1350, 241-1356
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DELIVERIES HANDLED
No. Case No. Diagnosis Name of Patient Age Date of Delivery Time of Gender Name of Hospital Type of Delivery Name and Signature of
Delivery of Baby Qualified Clinical Instructor
05 01997 Delivered Spontaneously to an alive Rosalie Flores 29 February 11, 2010 1:05 pm Female Guisok Lying -In Normal Spontaneous Pamela M. Veroy RN, MAN
Baby girl, Gravida 3 Para 3; Age of Vaginal Delivery
Gestation 39 weeks and 3 days
Prepared by:

Concurred by:
MARCELA P. GUISOK RM__________
Signature over printed name of Clinical Coordinator Signature over printed name of Dean of Nursing
Date Signed:_______________________________ Signature over printed name of Chief Nurse
Date Signed: ________________________ Date Signed: ______________________________
Degree: Master in Nursing___________________ Degree: Master of Arts in Nursing___________
Degree: Registered Midwife____________
a). PRC No.: 0368845________________________ a). PRC No.: 0079838______________________
a). PRC No:0039514__________________
Valid Until: January 28, 2011__________________ Valid Until: June 2, 2012____________________
Valid Until: June 29, 2013______________
b). PNA No. : 055100________________________ b). PNA No.: 055099_______________________
Valid Until: October 31, 2010_________________ Valid Until: October 31, 2010________________
ADPCN No.: 0827_________________________
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IP P IN E
Tel Nos: (082) 241-1350, 241-1356
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Fax No.: (082) 241-1351

DELIVERED ASSISTED
No. Case No. Diagnosis Name of Mother Age Date of Delivery Time of Gender Name of Hospital Type of Delivery Name and Signature of
Pregnancy Uterine Single alive

01 00-0073 Cephalic Baby boy Jovelyn Quimada 23 September 4, 2:11 am Male Mother’s Knows Best Normal Spontaneous Alberto S. Alejandre II, R.N.
Gravida 1 Parity 1 2009 Vaginal Delivery
02 00-0076 Pregnancy Uterine Single alive Darling Mintal 20 October 12, 2009 12:13 am Male Mother’s Knows Best Normal Spontaneous Alberto S. Alejandre II, R.N.
Cephalic Baby boy Vaginal Delivery
Gravida 1 Parity 1
03 00-0090 Pregnancy Uterine Single alive Elyn Layupan 24 February 01, 7:55 pm Female Mother’s Knows Best Normal Spontaneous Alberto S. Alejandre II, R.N.
Cephalic Baby boy 2010 Vaginal Delivery
Gravida 1 Parity 1
04 00-0091 Pregnancy Uterine Single alive Alma Utbo 29 February 25, 9:50 am Male Mother’s Knows Best Normal Spontaneous Alberto S. Alejandre II, R.N.
Cephalic Baby boy 2010 Vaginal Delivery
Gravida 1 Parity 1
Prepared by:

Signature over printed name of applicant Approved by:
Concurred by:
Noted by: LUDIVINA S. ALEJANDRE, RN, MaED, MAN
SYLVIA P. CASTILLO, RM________ Signature over printed name of Dean of Nursing
HILLARI BIANCA L. EUSEBIO, RN, MN_____ Signature over printed name of Chief Nurse Date Signed: ______________________________
Date Signed: _______________________ Degree: Master of Arts in Nursing___________
Signature over printed name of Clinical Coordinator
Degree: Registered Midwife_ _________ a). PRC No.: 0079838______________________
Date Signed:_______________________________
a). PRC No: 0017468_________________ Valid Until: June 2, 2012____________________
Degree: Master in Nursing___________________
Valid Until: February 20, 2011__________ b). PNA No.: 055099_______________________
a). PRC No.: 0368845________________________
Valid Until: January 28, 2011__________________
ADPCN No.: 0827_________________________
b). PNA No. : 055100________________________
Valid Until: October 31, 2010_________________
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Tel Nos: (082) 241-1350, 241-1356
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Fax No.: (082) 241-1351

DELIVERED ASSISTED
No. Case No. Diagnosis Name of Mother Age Date of Delivery Time of Gender Name of Hospital Type of Delivery Name and Signature of
05 02018 Delivered Spontaneously to an alive Felie Mae Pabio 32 February 26, 2010 8:50 pm Male Guisok Lying -In Normal Spontaneous Alberto S. Alejandre II, R.N
Baby boy, Gravida 6 Para 6; Age of Vaginal Delivery
Gestation 40 weeks and 3 days
Prepared by:

HILLARI BIANCA L. EUSEBIO, RN, MN_____ MARCELA P. GUISOK RM__________ LUDIVINA S. ALEJANDRE, RN, MaED, MAN
Date Signed:_______________________________ Date Signed: ________________________ Date Signed: ______________________________
Degree: Master in Nursing___________________ Degree: Registered Midwife____________ Degree: Master of Arts in Nursing___________
a). PRC No.: 0368845________________________ a). PRC No:0039514__________________ a). PRC No.: 0079838______________________
Valid Until: January 28, 2011__________________ Valid Until: June 29, 2013______________ Valid Until: June 2, 2012____________________
b). PNA No. : 055100________________________ b). PNA No.: 055099_______________________
Valid Until: October 31, 2010_________________ Valid Until: October 31, 2010________________
ADPCN No.: 0827_________________________

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Name of Student: ELDEN JOY TAYABAS CUBERO____________________________________________________

ELDEN JOY TAYABAS CUBERO

Noted by: Concurred by: Approved by:

Name of Student: ELDEN JOY TAYABAS CUBERO ___________________________________________________

ELDEN JOY TAYABAS CUBERO

Name of Student: ELDEN JOY TAYABAS CUBERO ___________________________________________________

ELDEN JOY TAYABAS CUBERO

JUAN G. PANUNCIO, BSN, RN________

Name of Student: ELDEN JOY TAYABAS CUBERO _______________________________________________________

ELDEN JOY TAYABAS CUBERO

JUAN G. PANUNCIO, BSN, RN________

Name of Student: ELDEN JOY TAYABAS CUBERO _______________________________________________________

ELDEN JOY TAYABAS CUBERO

Noted by: Concurred by: Approved by:

Name of Student: ELDEN JOY TAYABAS CUBERO _______________________________________________________

ELDEN JOY TAYABAS CUBERO

Name of Student: ELDEN JOY TAYABAS CUBERO _______________________________________________________

ELDEN JOY TAYABAS CUBERO

Name of Student: ELDEN JOY TAYABAS CUBERO ___________________________________________________

ELDEN JOY TAYABAS CUBERO

Name of Student: ELDEN JOY TAYABAS CUBERO _______________________________________________________

ELDEN JOY TAYABAS CUBERO

Name of Student: ELDEN JOY TAYABAS CUBERO ___________________________________________________

Pregnancy Uterine alive baby boy

ELDEN JOY TAYABAS CUBERO

Noted by: Concurred by: Approved by:

Name of Student: ELDEN JOY TAYABAS CUBERO ___________________________________________________

ELDEN JOY TAYABAS CUBERO

Concurred by: Approved by:

Name of Student: ELDEN JOY TAYABAS CUBERO _______________________________________________________

ELDEN JOY TAYABAS CUBERO

Name of Student: ELDEN JOY TAYABAS CUBERO ___________________________________________________

Pregnancy Uterine Single alive

ELDEN JOY TAYABAS CUBERO

Name of Student: ELDEN JOY TAYABAS CUBERO _______________________________________________________

ELDEN JOY TAYABAS CUBERO

Noted by: Concurred by: Approved by:

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