Page 1 of 5

Republic of the Philippines

Cebu Normal University
College of Nursing

Name of Student: JULIENNE DEO B. JABONILLO______ _____

Name and Address of School: CEBU NORMAL UNIVERSITY, Osmeña Boulevard, Cebu City __________________________
Accreditation Level (if any): III - AACCUP ________Year Granted: 2006 ___________________
Date School/ Program was Recognized: 1982 Number: CSC Board Resolution No. 35 Year: 1982 ____________
First Course (if any): NA School Graduated from: NA _______ Year: NA ___________________
Year of Admission in the Bachelor in Nursing Program: 2004 ____________
Year graduated (BSN Program: 2008 ___________________
I. MAJOR OPERATIONS
Signature
Date of Case Name of Type of of O.R.
No. Diagnosis Operation Performed Name of Surgeon Name of Hospital Name of O.R. Scrub Nurse
Operation No. Patient Anesthesia Scrub
Nurse
Vicente Sotto
March 20, Job Londite Excission of Mucocele via Lynch General Dr. Pamela
1 688053 Fronto-Ethmoidal Mucocele Left Memorial Medical Mrs. Ginny E. Aguilar, RN
2007 Calo Incission Anesthesia Masongsong
Center

Pregnancy Uterine Full Term,

Primary Low Segment Tranverse Vicente Sotto
An-an Calipayan Prolonged Labor secondary to Subarachnoid Dr. Medahlee J.
2 March 28, 690441 Caesarian Section with Prophylactic Memorial Medical Mrs. Lilian Delgado, RN
Celeste Cephalopelvic Disproportion, Preterm Block Carbonay
2007 Bilateral Artery Ligation Center
Premature Rupture of Membranes

Combined
Vicente Sotto
Arniel Davis Fracture, Middle Third Right Femur Open Reduction with Internal Fixation Spinal
3 May 28, 2007 690512 Dr. Kirby O. Lim Memorial Medical Mrs. Consuelo Tecling, RN
Alcaria secondary to Motor Vehicular Accident Intermedullary nailing Epidural
Center
Anesthesia
Vicente Sotto
Delfe Miñoza Spinal Dr. Max Joseph Mrs. Jessa F. Miramontes,
4 April 9, 2007 696328 Acute Suppurative Appendicitis Appendectomy Memorial Medical
Sungahid Anesthesia Montecillo RN
Center
Vicente Sotto
Jacqueline P. Subarachnoid Mr. Mark Anthony Apostol,
5 May 19, 2007 449024 Family Planning Acceptor Bilateral Tubal Ligation Dr. Jovita C. Yazar Memorial Medical
Manundan Block RN
Center
Prepared by:

JULIENNE DEO B. JABONILLO____

Name of Student

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

MRS. ANTONIETA G. OBIEDO DR. FLEOY T. YSMAEL _________ DR. ALMA B. UNGAB DR. MARYLOU B. ONG________
Signature over printed name of OR Coordinator Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse Signature over printed name of dean
Date Signed: Date Signed: ____________ Date Signed: Date Signed:___ ________________
Degree: BSN, RN, MN Degree: BSN, RN, MAN, Ed.D _____ Degree: BSN, RN, MN, DPA__ Degree: BSN, RN, MAN, DM ____
a.) PRC No.: 0176542 a.) PRC No.: 51093 _____ a.) PRC No.: _ 033477 a.) PRC No.: 53131________________
Valid Until: June 13, 2009 Valid Until: May 30, 2010 _____ Valid Until:_December 28, 2010 Valid Until: October 23,2009_____
b.) PNA No.: 16240 b.) PNA No.: 10460 _____ b.) PNA No.: 1847 b.) PNA No.: 3264 ____
Valid Until: Lifetime Valid Until: Lifetime _____ Valid Until: Lifetime Valid Until: Lifetime ____
c.) ANSAP No.: 011 c.) ADPCN No.: 153 ____
Valid Until: Lifetime Valid Until: 2008 ____
 Page 2 of 5

Republic of the Philippines

Cebu Normal University
College of Nursing

Name of Student: JULIENNE DEO B. JABONILLO_______ _____

Name and Address of School: CEBU NORMAL UNIVERSITY, Osmeña Boulevard, Cebu City __________________________
Accreditation Level (if any): III - AACCUP ________Year Granted: 2006 ___________________
Date School/ Program was Recognized: 1982 Number: CSC Board Resolution No. 35 Year: 1982 ____________
First Course (if any): NA School Graduated from: NA _______ Year: NA ___________________
Year of Admission in the Bachelor in Nursing Program: 2004 ____________
Year graduated (BSN Program: 2008 ___________________

II. MINOR OPERATIONS

Signatur
Date of Type of Name of O.R. e of O.R.
No. Case No. Name of Patient Diagnosis Operation Performed Name of Surgeon Name of Hospital
Operation Anesthesia Scrub Nurse Scrub
Nurse
Juvelyn Pepito Local Vicente Sotto Memorial
1 April 24, 2007 699409 Incomplete Abortion Complete Curettage Dr. Eden Aurora Opay Mrs. Agnes Egido, RN
Ornopia Anesthesia Medical Center
4 Cm Lacerated Wound Right Local Vicente Sotto Memorial
2 April 26, 2007 700368 Librado Abastas Suturing Dr. Roselda Ledesma Mrs. Agnes Egido, RN
Frontotemporal area Anesthesia Medical Center
Nick Anthony
Foreign Body (1 Peso Coin) Rigid Esophagoscopy and General Vicente Sotto Memorial Mrs. Lilian Delgado,
3 May 23, 2007 705613 Cabonellas Dr. Colina Colina
Ingestion Cricopharyngeal removal of foreign body anesthesia Medical Center RN
Fernandez
Regina Bia Local Vicente Sotto Memorial Mrs. Lilian Delgado,
4 May 24, 2007 705738 Incomplete Abortion Curettage Dr. Jovita Yazar
Paninsuron Anesthesia Medical Center RN
February 23, Pregnancy Uterine Full Term, Repair of Perineal Lacerations Local Vicente Sotto Memorial Ms. Anna Lissa
5 763084 Marivic Calumba Dr. Edelita Castor
2007 Cephalic in Labor G2 P1 Third Degree Anesthesia Medical Center Cosmiano

Prepared by:

JULIENNE DEO B. JABONILLO____

Name of Student

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

MRS. ANTONIETA G. OBIEDO DR. FLEOY T. YSMAEL _________ DR. ALMA B. UNGAB DR. MARYLOU B. ONG________
Signature over printed name of OR Coordinator Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse Signature over printed name of dean
Date Signed: Date Signed: ____________ Date Signed: Date Signed:___ ________________
Degree: BSN, RN, MN Degree: BSN, RN, MAN, Ed.D _____ Degree: BSN, RN, MN, DPA__ Degree: BSN, RN, MAN, DM ____
a.) PRC No.: 0176542 a.) PRC No.: 51093 _____ a.) PRC No.: _ 033477 a.) PRC No.: 53131________________
Valid Until: June 13, 2009 Valid Until: May 30, 2010 _____ Valid Until:_December 28, 2010 Valid Until: October 23,2009_____
b.) PNA No.: 16240 b.) PNA No.: 10460 _____ b.) PNA No.: 1847 b.) PNA No.: 3264 ____
Valid Until: Lifetime Valid Until: Lifetime _____ Valid Until: Lifetime Valid Until: Lifetime ____
c.) ANSAP No.: 011 c.) ADPCN No.: 153 ____
Valid Until: Lifetime Valid Until: 2008 ____
 Page 3 of 5
Republic of the Philippines
Cebu Normal University
College of Nursing

Name of Student: JULIENNE DEO B. JABONILLO______ ___________

Name and Address of School: CEBU NORMAL UNIVERSITY, Osmeña Boulevard, Cebu City __________________________
Accreditation Level (if any): III - AACCUP ________Year Granted: 2006 ___________________
Date School/ Program was Recognized: 1982 Number: CSC Board Resolution No. 35 Year: 1982 ____________
First Course (if any): NA School Graduated from: NA _______ Year: NA ___________________
Year of Admission in the Bachelor in Nursing Program: 2004 ____________
Year graduated (BSN Program: 2008 ___________________

III. ACTUAL DELIVERIES

Supervised by:
Time of Gender of
No. Case No. Diagnosis Name of Patient Age Date of Delivery Name of Hospital Type of Delivery Name & Signature of Qualified
Delivery Baby
C.I.
Pregnancy Uterine Full Vicente Sotto Memorial Normal Spontaneous
1 682880 Rubilyn Bariquit Prangos 27 January 29, 2007 7:09 PM Female Ms. Rengie Rentuma, RN
Term Medical Center Vaginal Delivery
Pregnancy Uterine Full Vicente Sotto Memorial Normal Spontaneous
2 698461 Virginia Tundag 37 April 18, 2007 5:28AM Female Ms. Opalyn Ybañez, RN
Term Medical Center Vaginal Delivery
Pregnancy Uterine Full Vicente Sotto Memorial Normal Spontaneous
3 710272 Jenilyn Cuysona Calvario 22 June 15, 2007 6:33 AM Female Ms Miriam Nayon, RN
Term Medical Center Vaginal Delivery

Pregnancy Uterine Full Vicente Sotto Memorial Normal Spontaneous

4 711801 Carmi Repollo Algoso 16 June 22, 2007 7:05 AM Female Ms Miriam Nayon, RN
Term Medical Center Vaginal Delivery
Pregnancy Uterine Full Vicente Sotto Memorial Normal Spontaneous
5 755616 Jennyvi Bayo Bueno 22 January 17, 2008 7:30 AM Male Ms Katrina Creer, RN
Term Medical Center Vaginal Delivery

Prepared by:

JULIENNE DEO B. JABONILLO

Name of Student
Supervised by: Noted by: Concurred by: Approved by:

MRS. AIDA A. INABANGAN DR. FLEOY T. YSMAEL _________ DR. ALMA B. UNGAB_ __________ __ ___ DR. MARYLOU B. ONG________
Signature over printed name of DR Coordinator Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse Signature over printed name of Dean
Date Signed: Date Signed: _________ Date Signed: ___ Date Signed: _______________
Degree: BSN, RN, MN Degree: BSN, RN, MAN, Ed.D______________ Degree: __BSN, RN, MN, DPA __ ___ Degree: BSN, RN, MAN, DM ____
a.) PRC No.: 0065350 a.) PRC No.: 51093 __ ______ a.) PRC No.: _ 033477 ___ a.) PRC No.: 53131 ___________
Valid Until: April 22, 2010 Valid Until: May 30, 2010 ____ ___ Valid Until:_December 28, 2010 ___ Valid Until: October 23, 2009________
b.) PNA No.: 07-CB-4826-1 b.) PNA No.: 10460 ___ b.) PNA No.: 1847 _ _______ b.) PNA No.: 3264 ___ ____
Valid Until: Lifetime _______ Valid Until: Lifetime __ _ Valid Until: Lifetime ________ __ Valid Until: Lifetime ____
c.) ANSAP No.: 011_ ___ __ c.) ADPCN No.: 153 ____
Valid Until: Lifetime __ Valid Until: 2008 ____
 Page 4 of 5

Republic of the Philippines

Cebu Normal University
College of Nursing

Name of Student: JULIENNE DEO B. JABONILLO_______

Name and Address of School: CEBU NORMAL UNIVERSITY, Osmeña Boulevard, Cebu City __________________________
Accreditation Level (if any): III - AACCUP ________Year Granted: 2006 ___________________
Date School/ Program was Recognized: 1982 Number: CSC Board Resolution No. 35 Year: 1982 ____________
First Course (if any): NA School Graduated from: NA _______ Year: NA ___________________
Year of Admission in the Bachelor in Nursing Program: 2004 ____________
Year graduated (BSN Program: 2008 ___________________

IV. ASSISTED DELIVERIES

Supervised by:
Date of Time of Gender of
No. Case No. Diagnosis Name of Patient Age Name of Hospital Type of Delivery Name & Signature of Qualified
Delivery Delivery Baby
C.I.
Normal
Pregnancy Uterine February 8, Vicente Sotto Memorial
1 684967 Elma Pitulan 20 12:05 AM Male Spontaneous Ms. Rengie Rentuma, RN
Full Term 2007 Medical Center
Vaginal Delivery
Normal
Pregnancy Uterine Vicente Sotto Memorial
2 708566 Medalibes Entero 26 June 9, 2007 5:39 PM Male Spontaneous Ms. Mepa Pogoy, RN
Full Term Medical Center
Vaginal Delivery
Normal
Pregnancy Uterine Vicente Sotto Memorial
3 705438 Emma Inday 29 June 16, 2007 12:35 PM Femlae Spontaneous Ms. Rengie Rentuma, RN
Full Term Medical Center
Vaginal Delivery

Prepared by:

JULIENNE DEO B. JABONILLO

Name of Student

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

MRS. AIDA A. INABANGAN DR. FLEOY T. YSMAEL _________ DR. ALMA B. UNGAB_ __________ __ ___ DR. MARYLOU B. ONG________
Signature over printed name of DR Coordinator Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse Signature over printed name of Dean
Date Signed: Date Signed: _________ Date Signed: ___ Date Signed: _______________
Degree: BSN, RN, MN Degree: BSN, RN, MAN, Ed.D______________ Degree: __BSN, RN, MN, DPA __ ___ Degree: BSN, RN, MAN, DM ____
a.) PRC No.: 0065350 a.) PRC No.: 51093 __ ______ a.) PRC No.: _ 033477 ___ a.) PRC No.: 53131 ___________
Valid Until: April 22, 2010 Valid Until: May 30, 2010 ____ ___ Valid Until:_December 28, 2010 ___ Valid Until: October 23, 2009________
b.) PNA No.: 07-CB-4826-1 b.) PNA No.: 10460 ___ b.) PNA No.: 1847 _ _______ b.) PNA No.: 3264 ___ ____
Valid Until: Lifetime _______ Valid Until: Lifetime __ _ Valid Until: Lifetime ________ __ Valid Until: Lifetime ____
c.) ANSAP No.: 011_ ___ __ c.) ADPCN No.: 153 ____
Valid Until: Lifetime __ Valid Until: 2008 ____
 Page 5 of 5

Republic of the Philippines

Cebu Normal University
College of Nursing

Name of Student: JULIENNE DEO B. JABONILLO______ __

Name and Address of School: CEBU NORMAL UNIVERSITY, Osmeña Boulevard, Cebu City __________________________
Accreditation Level (if any): III - AACCUP ________Year Granted: 2006 ___________________
Date School/ Program was Recognized: 1982 Number: CSC Board Resolution No. 35 Year: 1982 ____________
First Course (if any): NA School Graduated from: NA _______ Year: NA ___________________
Year of Admission in the Bachelor in Nursing Program: 2004 ____________
Year graduated (BSN Program: 2008 ___________________

V. CORD DRESSING
Supervised by:
No. Case No. Date Performed Name of Baby Gender of Baby Name of Mother Age Name of Hospital Name & Signature of Qualified
C.I.
Vicente Sotto Memorial Medical
1 702331 May 7, 2007 Leoniel Rhey Carampatan Male Jacqueline Crampatan 24 Mrs. Jillian A. Bejoc, RN
Center

Vicente Sotto Memorial Medical

2 702378 May 8, 2007 Glenn Powao Male Noemi Powao 37 Mrs. Jillian A. Bejoc, RN
Center

Vicente Sotto Memorial Medical

3 659857 May 8, 2007 Daphne Doreen Dela Torre Female Josephine Dela Torre 34 Mrs. Jillian A. Bejoc, RN
Center

Prepared by:

JULIENNE DEO B. JABONILLO

Name of Student

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

MRS. AIDA A. INABANGAN DR. FLEOY T. YSMAEL _________ DR. ALMA B. UNGAB_ __________ __ ___ DR. MARYLOU B. ONG________
Signature over printed name of DR Coordinator Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse Signature over printed name of Dean
Date Signed: Date Signed: _________ Date Signed: ___ Date Signed: _______________
Degree: BSN, RN, MN Degree: BSN, RN, MAN, Ed.D______________ Degree: __BSN, RN, MN, DPA __ ___ Degree: BSN, RN, MAN, DM ____
a.) PRC No.: 0065350 a.) PRC No.: 51093 __ ______ a.) PRC No.: _ 033477 ___ a.) PRC No.: 53131 ___________
Valid Until: April 22, 2010 Valid Until: May 30, 2010 ____ ___ Valid Until:_December 28, 2010 ___ Valid Until: October 23, 2009________
b.) PNA No.: 07-CB-4826-1 b.) PNA No.: 10460 ___ b.) PNA No.: 1847 _ _______ b.) PNA No.: 3264 ___ ____
Valid Until: Lifetime _______ Valid Until: Lifetime __ _ Valid Until: Lifetime ________ __ Valid Until: Lifetime ____
c.) ANSAP No.: 011_ ___ __ c.) ADPCN No.: 153 ____
Valid Until: Lifetime __ Valid Until: 2008 ____