Beruflich Dokumente
Kultur Dokumente
San Roque Extension, Roxas City 5800 Capiz, Philippines Telephone No.: (036) 621-0431 local 163 Fax No.: (036) 621-4185 Website: http://sach.dcphilippines.org
ODC Form 1A
ACTUAL DELIVERY FORM
Government Recognition No. 012; Series of 1982 July 6, 1981 ACTUAL DELIVERY in Hospital/Home/Lying-In Clinic, Municipality/City/Province Prepared by: Printed Name and Signature of Student: Date Performed and Time of Delivery Patients INITIAL only Case Number D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature not Required) SUPERVISED BY Clinical Instructor Name and Signature
PROCEDURE PERFORMED
Noted by: (Print Name and Signature) Clinical Coordinator, PRC I.D No. Date document is signed: Please specify Highest Nursing Degree Earned:
Approved by: (Print Name and Signature) Dean, PRC I.D No. Date document is signed: Specify Highest Nursing Degree Earned: (STRICTLY NO DESIGNATES)
ODC Form 1B
ASSISTED Delivery FORM
Government Recognition No. 012; Series of 1982 July 6, 1981 ACTUAL DELIVERY in Hospital/Home/Lying-In Clinic, Municipality/City/Province Prepared by: Printed Name and Signature of Student: Date Performed and Time of Delivery Patients INITIAL only Case Number
PROCEDURE PERFORMED
ASSISTED DELIVERY
D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature not Required)
Noted by: (Print Name and Signature) Clinical Coordinator, PRC I.D No. Date document is signed: Please specify Highest Nursing Degree Earned:
Approved by: (Print Name and Signature) Dean, PRC I.D No. Date document is signed: Specify Highest Nursing Degree Earned: (STRICTLY NO DESIGNATES)
ODC Form 1C
CORD CARE FORM
Government Recognition No. 012; Series of 1982 July 6, 1981 IMMEDIATE NEWBORN CORD CARE in Hospital/Home/Lying-In Clinic, Municipality/City/Province Prepared by: Printed Name and Signature of Student: Date Performed and Time of Delivery Patients INITIAL only Case Number Immediate Newborn Cord Care PERFORMED D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature not Required) SUPERVISED BY Clinical Instructor Name and Signature
Noted by: (Print Name and Signature) Clinical Coordinator, PRC I.D No. Date document is signed: Please specify Highest Nursing Degree Earned:
Approved by: (Print Name and Signature) Dean, PRC I.D No. Date document is signed: Specify Highest Nursing Degree Earned: (STRICTLY NO DESIGNATES)
ODC Form 2A
O.R. SCRUB FORM Major
Government Recognition No. 012; Series of 1982 July 6, 1981 SURGICAL SCRUB in Hospital, Municipality/City/Province Prepared by: Printed Name and Signature of Student: Date Performed and Time Started Patients INITIAL only Case Number O.R. Nurse On Duty (Name and Signature) SUPERVISED BY Clinical Instructor Name and Signature
Noted by: (Print Name and Signature) Clinical Coordinator, PRC I.D No. Date document is signed: Please specify Highest Nursing Degree Earned:
Approved by: (Print Name and Signature) Dean, PRC I.D No. Date document is signed: Specify Highest Nursing Degree Earned: (STRICTLY NO DESIGNATES)
ODC Form 2B
O.R. CIRCULATING FORM
Government Recognition No. 012; Series of 1982 July 6, 1981 SURGICAL SCRUB in Hospital, Municipality/City/Province Prepared by: Printed Name and Signature of Student: Date Performed and Time Started Patients INITIAL only Case Number O.R. Nurse On Duty (Name and Signature) SUPERVISED BY Clinical Instructor Name and Signature
Noted by: (Print Name and Signature) Clinical Coordinator, PRC I.D No. Date document is signed: Please specify Highest Nursing Degree Earned:
Approved by: (Print Name and Signature) Dean, PRC I.D No. Date document is signed: Specify Highest Nursing Degree Earned: (STRICTLY NO DESIGNATES)