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URDANETA CITY UNIVERSITY

(Formerly City Colleges of Urdaneta) Urdaneta City, Philippines-2428 Tel No. (075) 568-2475
Adopted from BON Resolution No. 357 Series of 2004

Name & Address of College of Nursing: URDANETA CITY UNIVERSITY URDANETA CITY, PANGASINAN Name of Student: AARON PAUL B. TOLENTINO Status of Accreditation: (if any) Level I Date Granted: 2011 Date Nursing/ Program of Nursing was Recognized: June 17, 1985 Recognition Number: 054

Last Course (if any): NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2007 Year Graduated (BSN Program): 2011

I. Major Operations
No . 1. Date of Operation September 14, 2010 Case No. 244797 Name of Patient Joel Paragas Aquino Aurora Faboso Bautista Laarni Tongson Colobong Diagnosis Open Fxtype III Left Tibia/Fibula Cholecystitis with cholelithiasis Uterine Myoma Operation Performed Below Knee Amputation Type of Anesthesia Spinal Anesthesia Spinal Anesthesia Spinal Anesthesia Name of Surgeon Dr. Sy Name of Hospital Pangasinan Provincial Hospital Name of Qualified Clinical Instructor Mr. Edwin De Vera Signature of Qualified Clinical Instructor Name of O.R. Scrub Nurse Ms. Kathleen Austria Ms. Joyce Guinto Ms. Kathleen Austria Signature of O.R. Scrub Nurse

2.

September 08, 2010 September 07, 2011

245355

Cholecistectomy Total Abdominal Bilateral Salpingo Ooperectomy

Dra. Sy

Pangasinan Provincial Hospital Pangasinan Provincial Hospital

Mr. Edwin De Vera

3.

249483

Dr. Ritumalta

Mr. Edwin De Vera

Prepared by: Name of Student: AARON PAUL B. TOLENTINO


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

MR. EDWIN DE VERA


Clinical Instructor

MRS. AURORA P.BAUTISTA


Chief Nurse

MRS. ANNALISA A. TELLES


Clinical Coordinator

MRS. ZOSIMA C. GARIN___


Dean, College of Nursing

PANGASINAN PROVINCIAL HOSPITAL


Date Signed: Degree: BSN, RN a.) PRC No.:0158187 Valid Until: December 23, 2011 b). PNA No.:2011-072992 Valid Until: December 31, 2011

PANGASINAN PROVINCIAL HOSPITAL


Date Signed: ___________________ Degree: BSN, RN, MPH, MAN a.) PRC No.:0062522 Valid Until: January 30, 2013 b). PNA No.:5707 Valid Until: Lifetime Member c.) ANSAP No. : 0383 Valid Until: Lifetime Member

URDANETA CITY UNIVERSITY


Date Signed: Degree: BSN, RN, MAN a.) PRC No.: 0201496 Valid Until: March 24, 2013 b.) PNA No.: 2011-072919 Valid Until: December 31, 2011

URDANETA CITY UNIVERSITY


Date Signed: Degree: BSN, RN, MAEd. MAN a.) PRC No.: 0075349 Valid Until: December 18, 2013 b.) PNA No.: 12163 Valid Until: Lifetime Member c). ADPCN No.:11-097 Valid Until: December31, 2011

URDANETA CITY UNIVERSITY


(Formerly City Colleges of Urdaneta) Urdaneta City, Philippines-2428 Tel No. (075) 568-2475
Adopted from BON Resolution No. 357 Series of 2004

Name & Address of College of Nursing: URDANETA CITY UNIVERSITY URDANETA CITY, PANGASINAN Name of Student: AARON PAUL B. TOLENTINO Status of Accreditation: (if any) Level I Date Granted: 2011 Date Nursing/ Program of Nursing was Recognized: June 17, 1985 Recognition Number: 054

Last Course (if any): NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2007 Year Graduated (BSN Program): 2011

II. Minor Operations


No. Date of Operation Case No. Name of Patient Diagnosis Old Unrepaired Vaginal Laceration, External Hemorrhoids, s/p Pereneoropy, s/p Hemorrhoidectomy Pregnancy 38-39 weeks LOA, delivery Spontaneous with Bilateral Tubal Ligation under spinal anesthesia Operation Performed Type of Anesthesia Name of Surgeon Name of Hospital Name of Qualified Clinical Instructor Signature of Qualified Clinical Instructor Name of O.R. Scrub Nurse Signature of O.R. Scrub Nurse

4.

June 08, 2010

556

Manangan Lailany

Perineorrh aphy & Hemorroid ectomy

Spinal Anesthesia

Dra. Rose marie C.Parinas & Dr.Darius R.Parinas

Urdaneta Sacred Heart Hospital

Mr. Michael Alvin T. Regis

Melvin Bagaoisan

5.

June 08, 2010

555

Gonatice Conchita

Bilateral Tubal Ligation

Spinal Anesthesia

Dra. Gladys B.Palagud

Urdaneta Sacred Heart Hospital

Mr. Michael Alvin T. Regis

Ms. Annie Leal

Prepared by: Name of Student: AARON PAUL B. TOLENTINO


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

MR. MICHAEL ALVIN T. REGIS


Clinical Instructor

MRS.BELEN A.ELEGORES
Assistant Chief Nurse

MRS.ANNALISA A.TELLES
Clinical Coordinator

MRS. ZOSIMA C. GARIN___


Dean, College of Nursing

URDANETA SACRED HEART HOSPITAL


Date Signed: Degree: BSN, RN a.) PRC No.:0357356 Valid Until: April 13, 2013 b). PNA No.: Valid Until:

URDANETA SACRED HEART HOSPITAL


Date Signed: Degree: BSN, RN, MPA, MAN a.) PRC No.:0135263 Valid Until: May 15, 2013 b). PNA No.: 12514 Valid Until: Lifetime Member c.) ANSAP No. : 10-1136 Valid Until: December 31, 2011

URDANETA CITY UNIVERSITY


Date Signed: Degree: BSN, RN, MAN a.) PRC No.: 0201496 Valid Until: March 24, 2013 b.) PNA No.: 2011-072919 Valid Until: December 31, 2011

URDANETA CITY UNIVERSITY


Date Signed: Degree: BSN, RN, MAEd. MAN a.) PRC No.: 0075349 Valid Until: December 18, 2013 b.) PNA No.: 12163 Valid Until: Lifetime Member c). ADPCN No.:11-097 Valid Until: December 31, 2011

URDANETA CITY UNIVERSITY


(Formerly City Colleges of Urdaneta) Urdaneta City, Philippines-2428 Tel No. (075) 568-2475
Adopted from BON Resolution No. 357 Series of 2004

Name & Address of College of Nursing: URDANETA CITY UNIVERSITY URDANETA CITY, PANGASINAN Name of Student: AARON PAUL B. TOLENTINO Status of Accreditation: (if any) Level I Date Granted: 2011 Date Nursing/ Program of Nursing was Recognized: June 17, 1985 Recognition Number: 054

Last Course (if any): NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2007 Year Graduated (BSN Program): 2011

III Actual Deliveries


No. 1. Case No. 2010698 Diagnosis Pregnancy Uterine Full Term, Gravida 3 Para 3 Pregnancy Uterine Full Term, Gravida 1 Para1 Pregnancy Uterine Full Term, Gravida 1 Para 1 Pregnancy Uterine Full Term, Gravida 1 Para 1 Name of Patient Myrna Oliveros Age 30 Date Of Delivery August 23, 2010 August 18, 2010 Time of Delivery 10:08 am Gender Of Baby Female Name of Hospital Rural HealthUnit Villasis Type Of Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Supervised By: Name & Signature of Qualified CI Mr. Eric Sanchez Mr. Eric Sanchez

2.

2010693

Rebecca Agpalo

22

12:15 pm

Male

Rural HealthUnit Villasis

3.

2010679

Beverly B. Henayas Jessa S. Cansintahan

23

August 10, 2010 August 04, 2010

3:44 pm

Female

Rural HealthUnit Villasis

Normal Spontaneous Delivery Normal Spontaneous Delivery

Mr. Eric Sanchez

4.

2010641

19

1:20 pm

Female

Rural HealthUnit Villasis

Mr. Eric Sanchez

Prepared by: Name of Student: AARON PAUL B. TOLENTINO


Supervised by: MRS.GLENDA TADENA Clinical Instructor DR. LAUREANO S. PEREZ MEMORIAL CLINIC Date Signed: Degree: BSN, RN, a.) PRC No.:0342008 Valid Until: March 03, 2013 b). PNA No.:2011-072946 Valid Until: December 31, 2011 Concurred by: MRS. TITA Z, SERNA Chief Nurse DR. LAUREANO S. PEREZ MEMORIAL CLINIC Date Signed: Degree: BSN, RN a.) PRC No.:0096046 Valid Until: June 28, 2011 b). PNA No.:2011-072947 Valid Until: December 31, 2011 Noted by: MRS. ANNALISA A .TELLES Clinical Coordinator URDANETA CITY UNIVERSITY Date Signed: Degree: BSN, RN, MAN a.) PRC No.: 0201496 Valid Until: March 24, 2013 b.) PNA No.: 2011-072919 Valid Until: December 31, 2011 Approved by: MRS. ZOSIMA C. GARIN Dean, College of Nursing URDANETA CITY UNIVERSITY Date Signed: Degree: BSN, RN, MAEd, MAN a.) PRC No.: 0075349 Valid Until: December 18, 2013 b.) PNA No.: 12163 Valid Until: Lifetime Member c). ADPCN No.:2011-097 Valid Until: December 31, 2011

URDANETA CITY UNIVERSITY


(Formerly City Colleges of Urdaneta) Urdaneta City, Philippines-2428 Tel No. (075) 568-2475
Adopted from BON Resolution No. 357 Series of 2004

Name & Address of College of Nursing: URDANETA CITY UNIVERSITY URDANETA CITY, PANGASINAN Name of Student: AARON PAUL B. TOLENTINO Status of Accreditation: (if any) Level I Date Granted: 2011 Date Nursing/ Program of Nursing was Recognized: June 17, 1985 Recognition Number: 054

Last Course (if any): NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2007 Year Graduated (BSN Program): 2011

IV. Assisted Deliveries


No. 1. Case No. 2010671 Diagnosis Pregnancy Uterine Full Term, Gravida 2 Para 2 Pregnancy Uterine Full Term, Gravida 1 Para 1 Name of Patient Laila B. Mones Age 28 Date Of Delivery August 10, 2010 Time of Delivery 11:10 am Gender Of Baby Female Name of Hospital Rural Healt Unit Villiasis Type Of Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Supervised By: Name & Signature of Qualified CI Mr. Eric Sanchez

2.

2010640

Novelyn Acosta

22

August 4, 2010

10:18 am

Male

Rural Healt Unit Villiasis

Mr. Eric Sanche

Prepared by: Name of Student: AARON PAUL B. TOLENTINO


Supervised by: Concurred by: Clinical Instructor MRS. TITA Z, SERNA Chief Nurse DR. LAUREANO S. PEREZ MEMORIAL CLINIC Date Signed: Degree: BSN, RN a.) PRC No.:0096046 Valid Until: June 28, 2014 b). PNA No.:2011-072947 Valid Until: December 2011 Noted by: MRS. ANNALISA A.TELLES Clinical Coordinator URDANETA CITY UNIVERSITY Date Signed: Degree: BSN, RN, MAN a.) PRC No.: 0201496 Valid Until: March 24, 2013 b.) PNA No.: 2011-072919 Valid Until: December 31, 2011 Approved by: MRS. ZOSIMA C. GARIN___ Dean, College of Nursing URDANETA CITY UNIVERSITY Date Signed: Degree: BSN, RN, MAEd. MAN a.) PRC No.: 0075349 Valid Until: December 18, 2013 b.) PNA No.: 12163 Valid Until: Lifetime Member c). ADPCN No.:11-097 Valid Until: December 31, 2011

MRS.GLENDA TADENA DR. LAUREANO S. PEREZ MEMORIAL CLINIC


Date Signed: Degree: BSN, RN a.) PRC No.:0342008 Valid Until: March 03, 2012 b). PNA No.:2011-072946 Valid Until: December 31, 2010

URDANETA CITY UNIVERSITY


(Formerly City Colleges of Urdaneta) Urdaneta City, Philippines-2428 Tel No. (075) 568-2475
Adopted from BON Resolution No. 357 Series of 2004

Name & Address of College of Nursing: URDANETA CITY UNIVERSITY URDANETA CITY, PANGASINAN Name of Student: AARON PAUL B. TOLENTINO Status of Accreditation: (if any) Level I Date Granted: 2011 Date Nursing/ Program of Nursing was Recognized: June 17, 1985 Recognition Number: 054
No. Case No. Date Performed Name of Baby Gender of Baby

Last Course (if any): NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2007 Year Graduated (BSN Program): 2011

I. Name of Dressing Cord Mother


Monica Tambio

Age

Name of Hospital

Supervised By: Name & Signature Of Qualified CI.

1.

5871

July 14, 2010

Mae Anne

Female

27

Urdaneta District Hospital Ms. Erzen A. Credo

2. 3. 4.

5866 5850 5823

July 14, 2010 July 13, 2010 July 12, 2010

Mary Anne Katherine Marvin

Female Female Male

Marites Bundoc Catherine Elegado Cherry Cayetano

32 22 31

Urdaneta District Hospital Ms. Erzen A. Credo Urdaneta District Hospital Ms. Erzen A. Credo Urdaneta District Hospital Ms. Erzen A. Credo

5.

5679

July 07, 2010

Chester

Male

Consuelo Proquinto

37

Urdaneta District Hospital

Ms. Erzen A. Credo

Prepared by: Name of Student: AARON PAUL B. TOLENTINO


Supervised by: Concurred by: Clinical Instructor Noted by: Chief Nurse MRS. ANNALISA A .TELLES Clinical Coordinator URDANETA CITY UNIVERSITY Date Signed: Degree: BSN, RN, MAN a.) PRC No.: 0201496 Valid Until: March 24, 2013 b.) PNA No.: 2011-072919 Valid Until: December 31, 2011 Approved by:

MRS.GLENDA TADENA DR. LAUREANO S. PEREZ MEMORIAL CLINIC


Date Signed: Degree: BSN, RN a.) PRC No.:0342008 Valid Until: March 03, 2013 b). PNA No.:2011-072946 Valid Until: December 31, 2010

MRS. TITA Z, SERNA DR. LAUREANO S. PEREZ MEMORIAL CLINIC


Date Signed: Degree: BSN, RN a.) PRC No.:0096046 Valid Until: June 28, 2014 b). PNA No.:2011-072947 Valid Until: December 31, 2011

MRS. ZOSIMA C. GARIN


Dean, College of Nursing

URDANETA CITY UNIVERSITY


Date Signed: Degree: BSN, RN, MAEd. MAN a.) PRC No.: 0075349 Valid Until: December 18, 2013 b.) PNA No.: 12163 Valid Until: Lifetime Member c). ADPCN No.:0713 Valid Until: December 31, 2011

URDANETA CITY UNIVERSITY


(Formerly City Colleges of Urdaneta) Urdaneta City, Philippines-2428 Tel No. (075) 568-2475
Adopted from BON Resolution No. 357 Series of 2004

Name & Address of College of Nursing: URDANETA CITY UNIVERSITY URDANETA CITY, PANGASINAN Name of Student: AARON PAUL B. TOLENTINO Status of Accreditation: (if any) Level I Date Granted: 2011 Date Nursing/ Program of Nursing was Recognized: June 17, 1985 Recognition Number: 054

Last Course (if any): NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2007 Year Graduated (BSN Program): 2011

II. Major Operations


No . Date of Operation Case No. Name of Patient Diagnosis Pregnancy Uterine Full Term, Gravida 1 Para 2 Pregnancy Uterine Full Term, Gravida 2 Para 1 Operation Performed Type of Anesthesia Name of Surgeon Name of Hospital Name of Qualified Clinical Instructor Marc Darwin L. Ragojos Marc Darwin L. Ragojos Signature of Qualified Clinical Instructor Name of O.R. Scrub Nurse Ms. Lala Dumlao Ms. Joanne Estanilla Signature of O.R. Scrub Nurse

1. 2.

July 26, 2010 July 13, 2010

7132 5851

Elgin Aguilar Rosalie Yabut

Emergency Caesarian Emergency Caesarian Pfannenstiel

Spinal Anesthesia Spinal Anesthesia

Dra. Luz Gandia Dr. Ephrain Lauchangco

Urdaneta District Hospital Urdaneta District Hospital

Name of Student: AARON PAUL B. TOLENTINO


Supervised by: MR. EDWIN DE VERA Clinical Instructor PANGASINAN PROVINCIAL HOSPITAL Date Signed: Degree: BSN, RN a.) PRC No.:0158187 Valid Until: December 23, 2011 b). PNA No: 2011-072992 Valid Until: December 31, 2010 Concurred by: MRS. AURORA P.BAUTISTA Chief Nurse PANGASINAN PROVINCIALHOSPITAL Date Signed: ___________________ Degree: BSN, RN, MPH, MAN a.) PRC No.:0062522 Valid Until: January30, 2013 b). PNA No.:5707 Valid Until: Lifetime Member c.) ANSAP No. : 0383 Valid Until: Lifetime Member Noted by: MS. ANNALISA A .TELLES Clinical Coordinator URDANETA CITY UNIVERSITY Date Signed: Degree: BSN, RN, MAN a.) PRC No.: 0201496 Valid Until: March 24, 2013 b.) PNA No.: 2011-072919 Valid Until: December 31, 2011 Approved by: MRS. ZOSIMA C. GARIN Dean, College of Nursing URDANETA CITY UNIVERSITY Date Signed: Degree: BSN, RN, MAEd. MAN a.) PRC No.: 0075349 Valid Until: December 18, 2013 b.) PNA No.: 12163 Valid Until: Lifetime Member c). ADPCN No.:0713 Valid Until: December 2011

URDANETA CITY UNIVERSITY


(Formerly City Colleges of Urdaneta) Urdaneta City, Philippines-2428 Tel No. (075) 568-2475
Adopted from BON Resolution No. 357 Series of 2004

Name & Address of College of Nursing: URDANETA CITY UNIVERSITY URDANETA CITY, PANGASINAN Name of Student: AARON PAUL B. TOLENTINO Status of Accreditation: (if any) Level I Date Granted: 2011 Date Nursing/ Program of Nursing was Recognized: June 17, 1985 Recognition Number: 054

Last Course (if any): NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2007 Year Graduated (BSN Program): 2011

III Actual Deliveries


No. Case No. Diagnosis Pregnancy Uterine Full Term, Gravida 2 Para 1 Name of Patient Age Date Of Delivery Time of Delivery Gender Of Baby Name of Hospital Urdaneta District Hospital Type Of Delivery Normal Spontaneous Delivery Supervised By: Name & Signature of Qualified CI Ms. Erzen A. Credo

5.

5820

Annie Luoang

28

July 12, 2010

7:48 pm

Female

Prepared by: Name of Student: AARON PAUL B. TOLENTINO


Supervised by: MRS. PERLA A.UMAGTAN Clinical Instructor PANGASINAN PROVINCIAL HOSPITAL Date Signed: Degree: BSN, RN a.) PRC No: 00342008 Valid Until: May 04, 2011 b). PNA No: 2011-07298 Valid Until: October 31, 2011 Concurred by: MRS. AURORA P. BAUTISTA Chief Nurse PANGASINAN PROVINCIALHOSPITAL Date Signed: ___________________ Degree: BSN, RN, MPH, MAN a.) PRC No: 0062522 Valid Until: January 2013 b). PNA No: 5707 Valid Until: Lifetime Member c.) ANSAP No: 02496 Valid Until: December 31, 2011 Noted by: MS. ANNALISA A .TELLES Clinical Coordinator URDANETA CITY UNIVERSITY Date Signed: Degree: BSN, RN, MAN a.) PRC No: 0201496 Valid Until: March 24, 2013 b.) PNA No: 2011-072919 Valid Until: December 31, 2011 Approved by: MRS. ZOSIMA C. GARIN___ Dean, College of Nursing URDANETA CITY UNIVERSITY Date Signed: Degree: BSN, RN, MAEd. MAN a.) PRC No: 0075349 Valid Until: December 18, 2013 b.) PNA No: 12163 Valid Until: Lifetime Member c). ADPCN No: 0713 Valid Until: December 31, 2011

URDANETA CITY UNIVERSITY


(Formerly City Colleges of Urdaneta) Urdaneta City, Philippines-2428 Tel No. (075) 568-2475
Adopted from BON Resolution No. 357 Series of 2004

Name & Address of College of Nursing: URDANETA CITY UNIVERSITY URDANETA CITY, PANGASINAN Name of Student: AARON PAUL B. TOLENTINO Status of Accreditation: (if any) Level I Date Granted: 2011 Date Nursing/ Program of Nursing was Recognized: June 17, 1985 Recognition Number: 054

Last Course (if any): NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2007 Year Graduated (BSN Program): 2011

IV. Assisted Deliveries


No. Case No. Diagnosis Pregnancy Uterine Full Term, Gravida 3 Para 2 Pregnancy Uterine Full Term, Gravida 1 Para 0 Pregnancy Uterine Full Term, Gravida 2 Para 1 Name of Patient Age Date Of Delivery Time of Delivery Gender Of Baby Name of Hospital Urdaneta District Hospital Urdaneta District Hospital Urdaneta District Hospital Type Of Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Supervised By: Name & Signature of Qualified CI Ms. Erzen A. Credo

3.

6075

Fatima Gumambao

22

July 21, 2010

08:48 pm

Female

4.

6046

Mary Joyce Cantavera

21

July 20, 2010

09:45pm

Male

Ms. Erzen A. Credo

5.

5659

Shiela Meriales

24

July 06, 2010

10:45 pm

Female

Ms. Erzen A. Credo

Prepared by: Name of Student: AARON PAUL B. TOLENTINO


Concurred by: Supervised by: MRS. PERLA UMAGTAN Clinical Instructor PANGASINAN PROVINCIAL HOSPITAL Date Signed: Degree: BSN, RN a.) PRC No.:0183535 Valid Until: May 14, 2011 b). PNA No.:061949 Valid Until: December 31, 2010 MRS. AURORA P. BAUTISTA Chief Nurse PANGASINAN PROVINCIALHOSPITAL Concurred by: Date Signed: ___________________ Degree: BSN, RN, MPH, MAN a.) PRC No.:0062522 Valid Until: January 2013 b). PNA No.:5707 Valid Until: Lifetime Member c.) ANSAP No. : 02496 Valid Until: December 31, 2011

Noted by: MRS. ANNALISA A .TELLES Clinical Coordinator URDANETA CITY UNIVERSITY Date Signed: Degree: BSN, RN, MAN a.) PRC No.: 0201496 Valid Until: March 24, 2013 b.) PNA No.: 2011-072919 Valid Until: December 31, 2011

Approved by: MRS. ZOSIMA C. GARIN___ Dean, College of Nursing URDANETA CITY UNIVERSITY Date Signed: Degree: BSN, RN, MAEd. MAN a.) PRC No.: 0075349 Valid Until: December 18, 2013 b.) PNA No.: 12163 Valid Until: Lifetime Member c). ADPCN No.:0713 Valid Until: December 31, 2013

URDANETA CITY UNIVERSITY


(Formerly City Colleges of Urdaneta) Urdaneta City, Philippines-2428 Tel No. (075) 568-2475
Adopted from BON Resolution No. 357 Series of 2004

Name & Address of College of Nursing: URDANETA CITY UNIVERSITY URDANETA CITY, PANGASINAN Name of Student: AARON PAUL B. TOLENTINO Status of Accreditation: (if any) Level I Date Granted: 2011 Date Nursing/ Program of Nursing was Recognized: June 17, 1985 Recognition Number: 054

Last Course (if any): NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2007 Year Graduated (BSN Program): 2011

IV. Assisted Deliveries


No. Case No. Diagnosis Pregnancy Uterine Full Term, Gravida 1 Para 1 Name of Patient Age Date Of Delivery Time of Delivery Gender Of Baby Name of Hospital Type Of Delivery Supervised By: Name & Signature of Qualified CI Mr. Michael Alvin Regis

5.

33

Mary Grace Fernandez

22

June 15, 2010

01:32 pm

Female

Urdaneta Sacred Heart Hospital

Normal Spontaneous Delivery

Prepared by: Name of Student: AARON PAUL B. TOLENTINO


Supervised by: MR.MICHAEL ALVIN REGIS Clinical Instructor URDANETA SACRED HEART HOSPITAL Date Signed: Degree: BSN, RN a.) PRC No.:0357256 Valid Until: April 13, 2013 b) PNA No: Valid Until: Concurred by: MRS.BELEN A.ELEGORES Chief Nurse URDANETA SACRED HEART HOSPITAL Date Signed: Degree: BSN, RN, MPA, MAN a.) PRC No: 0135263 Valid Until: May 15, 2013 b). PNA No.:12514 Valid Until: Lifetime Member c.) ANSAP No: 10-1136 Valid Until: December 31, 2011 Noted by: MS. ANNALISA A .TELLES Clinical Coordinator URDANETA CITY UNIVERSITY Date Signed: Degree: BSN, RN, MAN a.) PRC No.: 0201496 Valid Until: March 24, 2013 b.) PNA No.: 2011-072919 Valid Until: December 31, 2011 Approved by: MRS. ZOSIMA C. GARIN Dean, College of Nursing URDANETA CITY UNIVERSITY Date Signed: Degree: BSN, RN, MAEd. MAN a.) PRC No.: 0075349 Valid Until: December 18, 2013 b.) PNA No.: 12163 Valid Until: Lifetime Member c). ADPCN No.:0713 Valid Until: December 31, 2011

URDANETA CITY UNIVERSITY


(Formerly City Colleges of Urdaneta) Urdaneta City, Philippines-2428 Tel No. (075) 568-2475
Adopted from BON Resolution No. 357 Series of 2004

Name & Address of College of Nursing: URDANETA CITY UNIVERSITY URDANETA CITY, PANGASINAN Name of Student: AARON PAUL B. TOLENTINO Status of Accreditation: (if any) Level I Date Granted: 2011 Date Nursing/ Program of Nursing was Recognized: June 17, 1985 Recognition Number: 054

Last Course (if any): NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2007 Year Graduated (BSN Program): 2011

II. Minor Operations


No. Date of Operation Case No. Name of Patient Diagnosis Operation Performed Type of Anesthesia Name of Surgeon Name of Hospital Name of Qualified Clinical Instructor Mr. Don Martinez Signature of Qualified Clinical Instructor Name of O.R. Scrub Nurse Signature of O.R. Scrub Nurse

3.

July 14, 2010

7238

Samuel Ventura

Lacerated Wound at Left Eyebrow

Suturing

Local Sedation

Prepared by: Name of Student: AARON PAUL B. TOLENTINO


Supervised by: MR.DON MARTINEZ Clinical Instructor RHU-ROSALES Date Signed: Degree: BSN, RN a.) PRC No.:0357256 Valid Until: April 13, 2013 b) PNA No: 061978 Valid Until: December 2010 Concurred by: Noted by: MS. ANNALISA A .TELLES Clinical Coordinator URDANETA CITY UNIVERSITY Date Signed: Degree: BSN, RN, MAN a.) PRC No.: 0201496 Valid Until: March 24, 2013 b.) PNA No.: 2011-072919 Valid Until: December 31, 2011 Approved by: MRS. ZOSIMA C. GARIN___ Dean, College of Nursing URDANETA CITY UNIVERSITY Date Signed: Degree: BSN, RN, MAEd. MAN a.) PRC No.: 0075349 Valid Until: December 18, 2013 b.) PNA No.: 12163 Valid Until: Lifetime Member c). ADPCN No.:0713 Valid Until: December 31, 2013

MR.ALEJANDRINO DASIG JR Chief Nurse RHU-ROSALES Date Signed: Degree: BSN, RN, MAN a.) PRC No: 0256791 Valid Until: December 03, 2014 b). PNA No: 04794 Valid Until: Lifetime Member c.) ANSAP No: 09-0053 Valid Until: December 03, 2014

URDANETA CITY UNIVERSITY


(Formerly City Colleges of Urdaneta) Urdaneta City, Philippines-2428 Tel No. (075) 568-2475
Adopted from BON Resolution No. 357 Series of 2004

Name & Address of College of Nursing: URDANETA CITY UNIVERSITY URDANETA CITY, PANGASINAN Name of Student: AARON PAUL B. TOLENTINO Status of Accreditation: (if any) Level I Date Granted: 2011 Date Nursing/ Program of Nursing was Recognized: June 17, 1985 Recognition Number: 054
II. Minor Operations No . Date of Operation Case No. Name of Patient Diagnosis Incomplete Abortion 16 weeks Gravida 5 Para 4 Operation Performed Type of Anesthesia Name of Surgeon

Last Course (if any): NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: 2007 Year Graduated (BSN Program): 2011

Name of Hospital

Name of Qualified Clinical Instructor Mrs. Perla Umagtan

Signature of Qualified Clinical Instructor

Name of O.R. Scrub Nurse

Signature of O.R. Scrub Nurse

2.

August 24, 2010

244992

Satilyn De Guzman

Manual Vacuum Aspiration

Intravenous Sedation

Dr. Emmeline Geminiano

Pangasinan Provincial Hospital

Ms. Estelita Peralta

Name of Student: AARON PAUL B. TOLENTINO

Supervised by: MRS. PERLA UMAGTAN Clinical Instructor PANGASINAN PROVINCIAL HOSPITAL

Concurred by: MRS. AURORA P. BAUTISTA Chief Nurse PANGASINAN PROVINCIALHOSPITAL

Noted by: MS. ANNALISA A .TELLES Clinical Coordinator URDANETA CITY UNIVERSITY

Approved by: MRS. ZOSIMA C. GARIN___ Dean, College of Nursing URDANETA CITY UNIVERSITY

Date Signed: Degree: BSN, RN a.) PRC No.:00342008 Valid Until: May 04, 2011 b). PNA No.:2011-07298 Valid Until: October 31, 2011

Date Signed: ___________________ Degree: BSN, RN, MPH, MAN a.) PRC No.:0062522 Valid Until: January 30, 2013 b). PNA No.:5707 Valid Until: Lifetime Member c.) ANSAP No. : 0383 Valid Until: Lifetime Member

Date Signed: Degree: BSN, RN, MAN a.) PRC No.: 0201496 Valid Until: March 24, 2013 b.) PNA No.: 2011-072919 Valid Until: December 31, 2011

Date Signed: Degree: BSN, RN, MAEd. MAN a.) PRC No.: 0075349 Valid Until: December 18, 2013 b.) PNA No.: 12163 Valid Until: Lifetime Member c). ADPCN No.:0713 Valid Until: December 31, 2013

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